BACKGROUND Primary aorto-enteric fistula(PAEF)is a rare condition,traditionally treated in the acute,bleeding phase with open surgery or endovascular repair.However,these approaches have high morbidity and mortality,i...BACKGROUND Primary aorto-enteric fistula(PAEF)is a rare condition,traditionally treated in the acute,bleeding phase with open surgery or endovascular repair.However,these approaches have high morbidity and mortality,indicating a need for new methods.With advances in endoscopic techniques and equipment,haemoclipping of fistulas has now become feasible.Therefore,we present a systematic review of the English literature and a rare case of a PAEF successfully treated by endoscopic haemoclipping.CASE SUMMARY A 74-year-old man with an abdominal aortic aneurysm presented with symptoms of haemorrhagic shock and bloody stools.An oesophago-gastro-duodenoscopy was performed with haemoclipping of a suspected PAEF in the third part of the duodenum.Afterward,a computed tomography-angiography showed a contrast filled protrusion from the abdominal aortic aneurysm.Based on the clinical presentation and the combined endoscopic and radiographic findings,we argue that this is a case of a PAEF.CONCLUSION Endoscopic therapy appears capable of achieving haemodynamic stabilisation in patients with bleeding PAEF,serving as a bridge to final therapy.展开更多
文摘BACKGROUND Primary aorto-enteric fistula(PAEF)is a rare condition,traditionally treated in the acute,bleeding phase with open surgery or endovascular repair.However,these approaches have high morbidity and mortality,indicating a need for new methods.With advances in endoscopic techniques and equipment,haemoclipping of fistulas has now become feasible.Therefore,we present a systematic review of the English literature and a rare case of a PAEF successfully treated by endoscopic haemoclipping.CASE SUMMARY A 74-year-old man with an abdominal aortic aneurysm presented with symptoms of haemorrhagic shock and bloody stools.An oesophago-gastro-duodenoscopy was performed with haemoclipping of a suspected PAEF in the third part of the duodenum.Afterward,a computed tomography-angiography showed a contrast filled protrusion from the abdominal aortic aneurysm.Based on the clinical presentation and the combined endoscopic and radiographic findings,we argue that this is a case of a PAEF.CONCLUSION Endoscopic therapy appears capable of achieving haemodynamic stabilisation in patients with bleeding PAEF,serving as a bridge to final therapy.
