1/153. Aorto-oesophageal fistula presenting as a submucosal oesophageal haematoma.The CT findings in a fatal case of aorto-oesophageal fistula secondary to an atheromatous plaque in the thoracic aorta are described. These features are correlated with findings on endoscopy and barium studies.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
2/153. Primary aortoduodenal fistula.The aortoenteric fistula is a well-known but uncommon cause of gastrointestinal haemorrhage. It is usually secondary to previous reconstructive surgery of an abdominal aortic aneurysm. Primary aortoenteric fistula is a rare disorder which predominantly occurs in the duodenum. We report the case of a 76-year-old patient who presented with melaena and hypovolaemic shock due to a primary aortoduodenal fistula. Pathogenesis, diagnostic procedures and postmortem pathologic examination of this condition are discussed. The value of computed tomography in establishing the diagnosis is emphasized.- - - - - - - - - - ranking = 1.4keywords = fistula (Clic here for more details about this article) |
3/153. Primary aorto-duodenal fistula secondary to infected abdominal aortic aneurysms: the role of local debridement and extra-anatomic bypass.Gastrointestinal bleeding secondary to spontaneous rupture of an infected abdominal aortic aneurysm into the duodenum is a rare and highly lethal clinical occurrence, representing roughly a third of all primary aortoduodenal fistulas. diagnosis is problematic due to the subtleties in the clinical presentation and course, and surgical treatment is usually delayed, representing a challenge even for the experienced vascular surgeon. The overall mortality is over 30% and the operative approaches are still controversial. Two cases of ruptured infrarenal aortic aneurysms complicated with aortoduodenal fistula were recently treated at our institution. Bacterial aortitis was documented by arterial wall cultures positive for klebsiella and salmonella species respectively. The clinical courses and outcomes of the two patients (one survivor ) treated with retroperitoneal debridement and extra-anatomic bypass and a review of the modern surgical treatment are herein described.- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
4/153. A review of aortopulmonary fistulas in aortic dissection.Aortopulmonary fistula is an exceedingly rare complication of aortic dissection. Only 4 cases in acute dissection and 8 cases in the chronic one have been published previously. We report the thirteenth case and a review of the literature. A man underwent an operation for type A aortic dissection. At surgery, a fistula was discovered between the false lumen and the main pulmonary artery, although the preoperative investigations did not suggest such a complication.- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
5/153. Chyloperitoneum: a rare complication after abdominal aortic aneurysm repair.We report a case of chylous ascites as a rare complication following elective aortic aneurysm repair in a 66-year-old male. After early development of this condition on the second postoperative day, relaparotomy was performed with ligation of fistulae as well as omentoplasty. After recurrence of chylous ascites, conservative treatment consisting of parenteral nutrition and a low-fat diet for 3 months along with continuous peritoneal drainage finally led to successful resolution of this complication.- - - - - - - - - - ranking = 0.2keywords = fistula (Clic here for more details about this article) |
6/153. Endovascular treatment of an aortic aneurysm ruptured into the inferior vena cava.PURPOSE: To report the endovascular repair of a rare abdominal aortic aneurysm (AAA) rupture into the inferior vena cava. methods AND RESULTS: A 74-year-old man with a 6.0-cm saccular aortic aneurysm and a previously undiagnosed aortocaval fistula of more than 2 weeks' duration was treated successfully with a Vanguard bifurcated stent-graft. The aneurysm was excluded and no endoleak or communication between the aorta and inferior vena cava was seen on computed tomographic imaging at the 6-month evaluation. CONCLUSIONS: Aortic endografting in this life-threatening complication is an effective treatment option that avoids the significant blood loss encountered in conventional repair.- - - - - - - - - - ranking = 0.2keywords = fistula (Clic here for more details about this article) |
7/153. Primary aortoesophageal fistula: presenting as massive upper gastrointestinal hemorrhage.Primary aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. A six-year-old boy presented with massive upper gastrointestinal hemorrhage. endoscopy revealed a submucosal bulge in the esophagus with an ulcer and clot at the top. Lateral skiagram of the chest showed a posterior mediastinal mass. CT scan of the chest revealed a ruptured aortic aneurysm into the oesophagus, confirmed the diagnosis. The patient succumbed to the illness before he could be subjected to definitive treatment.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
8/153. Aorto-right artrial fistula: a rare complication of aortic dissection.We describe the successful surgical repair of an acute aortic dissection that had caused an aorto-right atrial fistula in a 67-year-old man. The patient was admitted to the hospital on an emergency basis because of severe heart failure. The diagnosis of acute aortic dissection with rupture into the right atrium was confirmed by use of intraoperative transesophageal echocardiography, although rupture of a sinus of valsalva aneurysm into the right atrium had been suggested initially by 2-dimensional and Doppler transthoracic echocardiography. At surgery, we found the patient to have aortic arch dissection with complete separation of the right coronary artery from the sinus of valsalva and a false lumen that had ruptured into the right atrium. The aortic arch was repaired directly. The ascending aorta was successfully replaced with a composite graft. Aortic dissection with rupture into the right atrium is extremely rare and leads to death rapidly. As shown in this case, such a condition might be mistaken for an aneurysmal rupture of the sinus of valsalva, with use of transthoracic echocardiography alone. Transesophageal echocardiography is a useful noninvasive method to further define or confirm the diagnosis. Early surgical intervention is necessary in patients with this condition to prevent profound shock and end-organ failure.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
9/153. Primary aortoduodenal fistula complicated by abdominal aortic aneurysm.A 74-year-old male patient was operated in Vakif Gureba Hospital for aortoduodenal fistula developing from abdominal aortic aneurysm. The patient was diagnosed as abdominal aortic aneurysm after physical examination and computed tomography in another center. Appearing of melena and hematemesis gastroduodenoscopy and radionuclide scanning was performed as diagnosis. After 6 days gastrointestinal bleeding recurred in massive haemorrhage and the patient was operated with a diagnosis of aortoenteric fistula as emergency. A midline laparotomy was performed. There was a fistula between infrarenal abdominal aortic aneurysm (with diameter 8x10 cm) and the 3rd portion of the duodenum. The duodenum was resected segmental and the fistula was disconnected. Following aneurysmotomy a prosthetic graft was placed in the aortobiiliac position. The patient was discharged at the 42nd postoperative day. Primary aortoenteric fistula is a very rare consequence of untreated abdominal aortic aneurysm. The segments of intestine most frequently involved in aortoenteric fistula are the 3rd and 4th portions of the duodenum. Clinical presentation is recurrent episodes of gross gastrointestinal haemorrhage. These cases have high mortality and morbidity unless evaluated as quickly as possible and appropriate surgical intervention performed.- - - - - - - - - - ranking = 2keywords = fistula (Clic here for more details about this article) |
10/153. Rupture of a thoracic aneurysm in the left bronchus.Aortobronchic fistula is a very unusual complication of thoracic aneurysm. We report the case of a 71-year old man with rupture of a thoracic aortic aneurysm in the left main bronchus. The patient had suffered a car crash fifteen years ago, without any evidence of aortic rupture at the time. Thereafter, he developed an aortic isthmic dilation (36 mm in diameter). The patient suffered from long standing pulmonary insufficiency and emphysema and was admitted several times on an urgent basis for acute dyspnea. During an hospitalization for respiratory distress, he presented haemoptysis and left lung hyperinflation secondary to partial fistulization and extrinsic compression of the main left bronchus. Isthmic aortic resection and prosthetic grafting was performed and the left main bronchus was closed by an autologous pericardial patch. Ten days later, following an air-leak from the bronchial closure, a transposed latissimus dorsi flap was used by the plastic surgeon to repair the defect. Nevertheless, the patient died from multisystemic failure six weeks later.- - - - - - - - - - ranking = 0.2keywords = fistula (Clic here for more details about this article) |
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