Masuda Mikio, Mitsuoka Hiroshi, Shintani Tsunehiro, Nakao Yoshinaga, Higashi Shigeki
Department of Vascular Surgery, Shizuoka Red Cross Hospital, Shizuoka, Japan.
Kyobu Geka. 2010 Aug;63(9):791-3.
Aortoenteric fistulas are a rare, but often fatal cause of gastrointestinal bleeding. This report describes the use of endovascular aneurysmal repair (EVAR) for the initial treatment of gastrointestinal bleeding possibly related to an aortoenteric fistula. A 69-year-old man with an abdominal aortic aneurysm was admitted to our hospital because of melena. He initially underwent EVAR. Upper and lower endoscopic examination failed to detect a bleeding site. Twenty-five days later, a fever of 38 degrees C developed, and endograft infection was diagnosed. The patient underwent an extra-anatomic bypass and total endograft explantation. He remains well 9 months after EVAR
主动脉肠瘘是胃肠道出血的一种罕见但通常致命的病因。本报告描述了使用血管内动脉瘤修复术（EVAR）对可能与主动脉肠瘘相关的胃肠道出血进行初始治疗的情况。一名患有腹主动脉瘤的69岁男性因黑便入住我院。他最初接受了EVAR。上下内镜检查未能发现出血部位。25天后，体温升至38摄氏度，诊断为人工血管感染。患者接受了解剖外旁路手术和完全取出人工血管。EVAR术后9个月他情况良好。
