Hirose H, Yagi M, Kimura T, Okabe H, Fujimoto A, Yoshitomi S, Tanaka J, Totsuka T, Hajiro A
Department of Surgery, Shimada Municipal Hospital, Shizuoka, Japan.
Minerva Cardioangiol. 1998 Jul-Aug;46(7-8):255-9.
A rare case, presented as a secondary aortoenteric fistula after an abdominal aortic aneurysmectomy with Y-graft replacement 9 months earlier, is reported. The course was clinically very unique, in that the first manifestation of the aorto enteric fistula occurred while the patient had already been hospitalized after the orthopaedic surgical treatment for the pyogenic vertebral spondylitis. After the episode of gastrointestinal bleeding, radiological studies were promptly collected, and with the proper diagnosis, a successful surgical treatment was given under the stable hemodynamic condition, and the patient recovered uneventfully. Retrospectively considered, there are several findings that would suggest that seemingly a secondary aorto enteric fistula could have resulted from an early process of the primary aorto enteric fistula having been under progress without any detectable manifestations before the previous aneurysmectomy. The diagnostic values of computed tomography and the scintigraphy for this rare clinical entity is also underlined.
本文报道了一例罕见病例，该患者在9个月前接受腹主动脉瘤切除并Y型人工血管置换术后出现继发性主动脉肠瘘。其病程在临床上非常独特，因为主动脉肠瘘的首发表现发生在患者因化脓性脊椎炎接受骨科手术治疗后已住院期间。在发生胃肠道出血事件后，迅速进行了影像学检查，并在正确诊断后，在血流动力学稳定的情况下进行了成功的手术治疗，患者顺利康复。回顾性分析发现，有几个迹象表明，看似继发性主动脉肠瘘可能是由原发性主动脉肠瘘的早期进程导致的，该进程在之前的动脉瘤切除术之前一直在进行，但没有任何可检测到的表现。本文还强调了计算机断层扫描和闪烁扫描对这种罕见临床病症的诊断价值。
