Aorto-enteric fistula(AEF)is a rare entity that accounts for high mortality. Early diagnosis is paramount to improving the survivals of patients with AEF but the diagnosis tends to be delayed in practice due to extrem...Aorto-enteric fistula(AEF)is a rare entity that accounts for high mortality. Early diagnosis is paramount to improving the survivals of patients with AEF but the diagnosis tends to be delayed in practice due to extremely variable clinical presentations. Contrasted computer tomography(CT),oesophagastroduodenoscopy(OGDS)or angiography should be prompted in a timely manner based on a high index of clinical suspicion. In this article,a case of primary AEF(PAEF)with herald gastroenteric tract haemorrhage is presented. In addition to the pathophysiology and managements,the pitfalls of the diagnostic studies are discussed,pinpointing the importance of high index of clinical suspicion.展开更多
Primary aorto-enteric fistula(PAEF)develops between the native aorta and the gastro-intestinal tract,in the presence of an abdominal aortic aneurysm.It is a rare,life-threatening condition and appears to be less frequ...Primary aorto-enteric fistula(PAEF)develops between the native aorta and the gastro-intestinal tract,in the presence of an abdominal aortic aneurysm.It is a rare,life-threatening condition and appears to be less frequent than secondary aortoenteric fistula,which is associated with previous aortic prosthetic reconstruction.When untreated,the overall mortality rate is almost 100%.Diagnosis may be challenging until the occurrence of a massive haemorrhage.In the presence of gross contamination,patients tend to a worse prognosis.Extra-anatomical bypass and repair of the enteric tract is the treatment of choice in case of gross contamination.In situ reconstruction is often reported in cases of mild bacterial contamination.Endovascular treatment has recently become a valid option in haemodynamically unstable patients,but a staged approach,with delayed surgical treatment,seems advisable.展开更多
文摘Aorto-enteric fistula(AEF)is a rare entity that accounts for high mortality. Early diagnosis is paramount to improving the survivals of patients with AEF but the diagnosis tends to be delayed in practice due to extremely variable clinical presentations. Contrasted computer tomography(CT),oesophagastroduodenoscopy(OGDS)or angiography should be prompted in a timely manner based on a high index of clinical suspicion. In this article,a case of primary AEF(PAEF)with herald gastroenteric tract haemorrhage is presented. In addition to the pathophysiology and managements,the pitfalls of the diagnostic studies are discussed,pinpointing the importance of high index of clinical suspicion.
文摘Primary aorto-enteric fistula(PAEF)develops between the native aorta and the gastro-intestinal tract,in the presence of an abdominal aortic aneurysm.It is a rare,life-threatening condition and appears to be less frequent than secondary aortoenteric fistula,which is associated with previous aortic prosthetic reconstruction.When untreated,the overall mortality rate is almost 100%.Diagnosis may be challenging until the occurrence of a massive haemorrhage.In the presence of gross contamination,patients tend to a worse prognosis.Extra-anatomical bypass and repair of the enteric tract is the treatment of choice in case of gross contamination.In situ reconstruction is often reported in cases of mild bacterial contamination.Endovascular treatment has recently become a valid option in haemodynamically unstable patients,but a staged approach,with delayed surgical treatment,seems advisable.
