La Greca Gaetano, Barbagallo Francesco, Gagliardo Salvatrice, Latteri Saverio, Scala Vincenzo, Sofia Maria, Russello Domenico
Department of Surgical Science, Transplantation and Advanced Technologies, Cannizzaro Hospital, University of Catania, Via Messina 354, Catania, Italy.
Ann Vasc Surg. 2011 Apr;25(3):386.e7-386.e11. doi: 10.1016/j.avsg.2010.11.006. Epub 2011 Jan 26.
Aortoenteric fistula is defined as a communication between the aorta and an adjacent loop of the bowel and is often the cause of devastating upper gastrointestinal tract bleeding with only few survivors. According to the etiology, the aortoenteric fistulas are classified as primary aortoenteric fistula or secondary aortoenteric fistula (SAEF) after previous aortic surgery. The recurrence of a fistula on a previous SAEF is defined as recurrent aortoenteric fistula and is reported only in a few rare cases occurring within an unpredictable period from the previous surgical treatment. We describe a unique case of recurrent aortoenteric fistula, in which the relationship with recurrence consisted of the presence of the metallic clips of a stapled suture to close the duodenal wall during the previous SAEF repair. A review of the published data on this subject was performed to analyze the clinical features, the overall results, the risk factors of recurrence, and the main technical points of surgical treatment to prevent it.
主动脉肠瘘被定义为主动脉与相邻肠袢之间的连通，它常常是导致严重上消化道出血的原因，幸存者寥寥无几。根据病因，主动脉肠瘘可分为原发性主动脉肠瘘或先前主动脉手术后的继发性主动脉肠瘘（SAEF）。先前SAEF患者瘘管复发被定义为复发性主动脉肠瘘，仅在少数罕见病例中有报道，且复发时间不可预测，发生于先前手术治疗后的某个时期。我们描述了一例独特的复发性主动脉肠瘘病例，其中复发与之前SAEF修复术中用于闭合十二指肠壁的吻合器缝线金属夹的存在有关。我们对该主题已发表的数据进行了回顾，以分析其临床特征、总体结果、复发危险因素以及预防复发的手术治疗主要技术要点。
