Ahn Su Young, Lee Sun Young, Kim Bum Sung, Rhee Kyoung Hoon, Kim Jeong Hwan, Sung In Kyung, Park Hyung Seok, Jin Choon Jo
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2010 Jan;55(1):62-7. doi: 10.4166/kjg.2010.55.1.62.
Gastrointestinal complications (GI) after thoracoabdominal aortic repair can be classified as biliary disease, heptic dysfunction, pancreatitis, GI bleeding, peptic ulcer disease, bowel ischemia, paralytic ileus, and aortoenteric fistula. Theses complications are associated with high post operative morbidity and mortality. Most of the aortoenteric fistulae after thoracoabdominal aortic surgery are found at the duodenum, near the surgical site. These rare complications are caused by an indirect communication with abdominal aorta that originated from an aneursymal formation ruptured into the duodenum. Such aorto-duodenal fistula formation is considered as a result of inflammatory change from secondary infection near the surgical instruments. Herein, we report two cases of massive upper GI bleeding from aorto-duodenal fistulae and spontaneous lower GI perforation related to cytomegalovirus infection after abdominal aortic aneurysmal repair operations.
胸腹主动脉修复术后的胃肠道并发症（GI）可分为胆道疾病、肝功能障碍、胰腺炎、胃肠道出血、消化性溃疡病、肠缺血、麻痹性肠梗阻和主动脉肠瘘。这些并发症与术后高发病率和死亡率相关。胸腹主动脉手术后的大多数主动脉肠瘘发生在十二指肠，靠近手术部位。这些罕见的并发症是由与腹主动脉的间接沟通引起的，该沟通起源于破裂进入十二指肠的动脉瘤形成。这种主动脉十二指肠瘘的形成被认为是手术器械附近继发感染引起的炎症变化的结果。在此，我们报告两例腹主动脉瘤修复术后因主动脉十二指肠瘘导致大量上消化道出血和与巨细胞病毒感染相关的自发性下消化道穿孔的病例。
