Images in Clinical Medicine
Aortoenteric Fistula
N Engl J Med 1997; 336:27January 2, 1997
- Article
Figure 1 A 76-year-old man with a three-day history of crampy abdominal pain presented to the hospital with melena and a near-syncopal episode. Sixteen years earlier he had undergone successful surgery to repair an abdominal aortic aneurysm. His blood pressure and pulse were 144/82 mm Hg and 118 per minute, respectively, while he was lying down and 132/80 mm Hg and 147 per minute while he was standing. Abdominal examination revealed mild tenderness in the left and right lower quadrants. The gastric contents had a coffee-ground appearance, which cleared with lavage. Esophagogastroduodenoscopy revealed a normal-appearing esophagus, stomach, and duodenum. Small-bowel enteroscopy showed a raised, pulsating, ulcerated lesion measuring 2 cm by 2 cm in the proximal jejunum (arrowhead). The patient was taken immediately to the operating room, where an eroded right iliac anastomosis was found to have ruptured into the proximal jejunum, creating an aortoenteric fistula. The original graft was resected, and a new right subclavian–bi-iliac graft was constructed. The patient was sent to a nursing home in stable but frail condition after four weeks of hospitalization. He died of pneumonia four months later.
William Abernethy, M.D.
John H. Sekijima, M.D.
Seattle Veterans Affairs Medical Center, Seattle, WA 98108- Citing Articles (2)
Citing Articles
1
J.L.M. Bruggink, A.W.J.M. Glaudemans, B.R. Saleem, R. Meerwaldt, H. Alkefaji, T.R. Prins, R.H.J.A. Slart, C.J. Zeebregts. (2010) Accuracy of FDG-PET–CT in the Diagnostic Work-up of Vascular Prosthetic Graft Infection. European Journal of Vascular and Endovascular Surgery 40:3, 348-354
CrossRef2
Kie Honjo, Hiroyuki Okada, Kengo Sumii, Toshitsugu Kobatake, Shinichi Fujioka, Isao Kumagai, Sho Takeda, Akira Teraoka. (2004) ENDOSCOPY IS ONE OF THE VALUABLE DIAGNOSTIC METHODS FOR PRIMARY AORTO-ENTERIC FISTULA. Digestive Endoscopy 16:4, 353-355
CrossRef
