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腹主动脉肠瘘的血管内治疗。

Endovascular Treatment of Abdominal Infection-induced Aortoenteric Fistula.

机构信息

Departments of Cardiovascular Surgery, Gastrointestinal Surgery, and Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Ann Thorac Surg. 2022 Oct;114(4):e275-e277. doi: 10.1016/j.athoracsur.2021.12.013. Epub 2022 Jan 6.

Abstract

Primary aortoenteric fistula is a rare clinical entity that often has a fatal outcome. It usually arises from an atherosclerotic aneurysm, and induction by abdominal infection is extremely rare. This report presents the case of 54-year-old man with a history of aortic arch replacement and elephant trunk stent implantation 6 years earlier for Stanford type A aortic dissection. At 11 months before his current presentation, he underwent enteroscopy, during which gastrointestinal perforation occurred. Since then, he had experienced episodes of syncope and hemorrhage. Finally, a fistula was found on imaging. Endovascular treatment and digestive tract repair were accomplished. At 13-month follow-up, he had not had a recurrence of hematochezia or fever.

摘要

原发性主动脉肠瘘是一种罕见的临床病症,常导致致命后果。它通常由动脉粥样硬化性动脉瘤引起,而由腹部感染引起则极为罕见。本报告介绍了一位 54 岁男性患者的病例,他在 6 年前因 Stanford 型 A 型主动脉夹层而行主动脉弓置换和象鼻支架植入术。在本次就诊前 11 个月,他接受了内镜检查,在此期间发生了胃肠道穿孔。此后,他经历了晕厥和出血发作。最终,影像学检查发现了瘘管。完成了血管内治疗和消化道修复。在 13 个月的随访中,他没有再次出现血便或发热。

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