Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, 1-10 Ami-dong, Seo-gu, Busan, 602-739, Korea.
J Anesth. 2012 Dec;26(6):910-3. doi: 10.1007/s00540-012-1445-z. Epub 2012 Jul 15.
We report a case of a patient with a double-primary aortoenteric fistula with an abdominal aortic aneurysm. A 75-year-old man was taken to the operating room for the repair of an abdominal aortic aneurysm and a suspected aortoenteric fistula between the aorta and sigmoid colon. Sudden onset of massive bleeding through the nasogastric tube occurred after the induction of anesthesia. Surgical exploration confirmed an unexpected aortoduodenal fistula. Primary aortoenteric fistula is extremely rare and difficult to diagnose, and may cause fatal bleeding. The possibility of the presence of aortoenteric fistula, including multiple types, should be considered in the anesthetic management of abdominal aortic aneurysm.
我们报告了一例双重原发性主肠瘘合并腹主动脉瘤的病例。一名 75 岁男性因腹主动脉瘤和主动脉与乙状结肠之间疑似主肠瘘而被送入手术室进行修复。麻醉诱导后，患者通过鼻胃管突然发生大量出血。手术探查证实为意外的主肠瘘。原发性主肠瘘极为罕见且难以诊断，可能导致致命性出血。在腹主动脉瘤的麻醉管理中，应考虑包括多种类型的主肠瘘的存在。
