Lee Burm, Gutherz Neschis David
Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Vasc Endovascular Surg. 2010 Jul;44(5):395-8. doi: 10.1177/1538574410366761. Epub 2010 May 18.
Aortoenteric fistula is a devastating complication of aortic aneurysm repair. Traditional repair carries a high risk of mortality and significant morbidity. While endograft repair can be effective at mitigating the immediate life-threatening bleed, the temptation to consider endograft repair as definitive treatment should be resisted. We present a case of a 72 year old male who developed an aortoenteric fistula four years following surgical repair of a ruptured aortic aneurysm. Four years thereafter the patient developed infection of the graft and required extra-anatomic bypass and excision of the infected graft. Endograft repair of aortoenteric fistula is associated with persistent infection and should be viewed as a temporizing measure. Here we present the case and review the literature regarding the treatment and outcome of this condition.
主动脉肠瘘是主动脉瘤修复术后的一种严重并发症。传统修复术具有较高的死亡率和显著的发病率。虽然腔内修复术在减轻即刻危及生命的出血方面可能有效,但应避免将腔内修复术视为确定性治疗方法。我们报告一例72岁男性患者,他在破裂性主动脉瘤手术修复四年后发生了主动脉肠瘘。四年后,患者发生了人工血管感染,需要进行解剖外旁路移植术并切除感染的人工血管。主动脉肠瘘的腔内修复术与持续性感染相关,应被视为一种临时措施。在此我们报告该病例并回顾关于这种疾病治疗及转归的文献。