Runkel N, Riede E, Kroesen A J, Wiegel T, Buhr H J
Chirurgische Klinik und Poliklinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin.
Chirurg. 1998 Aug;69(8):883-6. doi: 10.1007/s001040050507.
Non-traumatic duodenocaval fistulae are rare, but may be the source of massive gastrointestional bleeding with associated fever and sepsis. These fistulae result from penetrating duodenal peptic ulcers or right nephrectomy and subsequent radiation to the upper abdomen. The outcome depends on early diagnosis and surgery before a potentially fatal hemorrhage occurs. The therapy of choice includes closure of the fistula and repair of the duodenum and inferior vena cava. We describe the seventh case with radiogenic duodenal ulcer. Gastrointestinal bleeding occurred 10 years after radical nephrectomy and radiation (60 Gy). The patient survived following partial pancreatoduodenectomy (Whipple).
非创伤性十二指肠腔静脉瘘很少见，但可能是大量胃肠道出血并伴有发热和败血症的原因。这些瘘是由十二指肠消化性溃疡穿孔或右肾切除术后对上腹部进行放疗引起的。其预后取决于在潜在致命性出血发生前的早期诊断和手术。首选的治疗方法包括瘘管闭合以及十二指肠和下腔静脉修复。我们描述了第7例放射性十二指肠溃疡病例。在根治性肾切除和放疗（60 Gy）10年后发生了胃肠道出血。患者在接受胰十二指肠部分切除术（惠普尔手术）后存活。
