Vilas-Boas Filipe, Azevedo Fernando, Marques Margarida, Baldaque-Silva Francisco, Cardoso Hélder, Costa-Lima J, Macedo Guilherme
Department of Gastroenterology, Faculty of Medicine, Centro Hospitalar de S. João, Alameda Prof. Hernani Monteiro, 4200-319, Porto, Portugal.
Department of Vascular Surgery, Faculty of Medicine, Centro Hospitalar de S. João, Alameda Prof. Hernani Monteiro, 4200-319, Porto, Portugal.
Clin J Gastroenterol. 2013 Aug;6(4):299-302. doi: 10.1007/s12328-013-0401-2. Epub 2013 Jun 23.
Primary aortoenteric fistula is a rare complication of aortic aneurysms. This cause of gastrointestinal bleeding poses significant diagnostic challenges due to its nonspecific presentation. We report a case of an 80-year-old man with right flank pain and rectal bleeding. The patient had been admitted 2 weeks before with the same symptoms. Upper and lower endoscopies were unremarkable, but abdominal computed tomography scan showed evidence of aortoduodenal fistula. An emergency laparotomy with aortic bypass and fistula closure was performed and the patient was able to recover in the following weeks. This case highlights the need for a high index of suspicion to avoid diagnostic delay that frequently has fatal results.
原发性主动脉肠瘘是主动脉瘤的一种罕见并发症。这种导致胃肠道出血的病因因其非特异性表现而带来重大的诊断挑战。我们报告一例80岁男性患者，有右侧胁腹疼痛和直肠出血症状。该患者在两周前因相同症状入院。上下消化道内镜检查均无异常，但腹部计算机断层扫描显示存在主动脉十二指肠瘘。遂进行了急诊剖腹手术，行主动脉搭桥和瘘管闭合术，患者在接下来的几周内得以康复。该病例凸显了需要高度怀疑，以避免经常导致致命后果的诊断延误。
