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降主动脉血管内修复术后并发主动脉-胃瘘致猝死 1 例罕见报告

A rare case of sudden death due to aortogastric fistula after endovascular aortic repair of the descending aorta.

机构信息

Department of Forensic Medicine and Toxicology, Greece M. Asias, School of Medicine, National and Kapodistrian University of Athens, 115 27, Athens, Greece.

出版信息

Forensic Sci Med Pathol. 2021 Sep;17(3):461-464. doi: 10.1007/s12024-021-00374-0. Epub 2021 May 5.

Abstract

Aortogastric fistulas are a rare type of aortoenteric fistula (AEF). Aortoenteric fistulas have been reported as a complication of endovascular aortic repair (EVAR) after the placement of prosthetic materials. Considering the anatomic relationship of the descending thoracic aorta and the stomach, the formation of an aortic fistula involving the stomach is an extremely rare case. We report the case of a 77-year-old woman who was admitted to the hospital due to severe mid-thoracic chest pain and was diagnosed with upper gastrointestinal bleeding. Her medical history included an aneurysm of the descending thoracic aorta, which was treated using the Thoracic Endovascular Repair (TEVAR) method several months prior. The patient died a few hours later amid hemorrhagic shock. The autopsy confirmed the upper gastrointestinal bleeding and revealed a fistula between the descending thoracic aorta and stomach, which were in anatomic contact because of a sliding hiatus hernia.

摘要

主动脉-胃瘘是一种罕见的主动脉-肠瘘(AEF)类型。主动脉-肠瘘是血管内主动脉修复(EVAR)后放置人工材料的并发症之一。考虑到降主动脉和胃的解剖关系,涉及胃的主动脉瘘的形成是一种极其罕见的情况。我们报告了一例 77 岁女性患者,因严重的中胸部胸痛入院,并被诊断为上消化道出血。她的病史包括几个月前使用胸主动脉腔内修复(TEVAR)方法治疗的降主动脉瘤。患者几小时后死于失血性休克。尸检证实了上消化道出血,并发现降主动脉和胃之间存在瘘管,由于滑动裂孔疝,它们处于解剖接触状态。

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