Aortoenteric fistulas — case report series from the Department of Surgery of the 4. Military Clinical Hospital in Wroclaw over the years 2010–2016
Abstract
Background. Aortoenteric fistulas constitute a rare, but severe clinical problem involving a pathological
connection between the abdominal aorta and gastrointestinal tract. We distinguish primary and, much more
frequent, secondary fistulas. All such fistulas require urgent surgical treatment. Currently, the most common
treatment method involves open in situ prosthesis replacement or an extra-anatomical by-pass. Endovascular
procedures offer an alternative to open surgery, but remain controversial.
Material and methods. The analysis included 6 surgical procedures in 5 patients with aorto-duodenal fistula
treated at the Department of Surgery of the 4. Military Clinical Hospital over the years 2010–2016. Open
surgery was performed in 4 cases, while 2 patients underwent stentgraft implantation. Diagnostics consisted of
an angio-CT and upper gastrointestinal tract endoscopy. All patients were diagnosed with radiological signs of
prosthesis infection, 2 of 6 patients died during the perioperative period. Surgical complications were observed
in 5 of 6 cases (83%).
Results. Endovascular treatment was associated with a reduction in the number of early postoperative complications
and shortening of hospital stay.
Conclusions. Based on the results and literature data, stentgraft implantation into the aorto-duodenal fistula
appears to be a viable alternative treatment method.
Keywords: stentgraftaorto-duodenal fistulaaortic prosthesisabdominal aortagastrointestinal hemorrhage
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