1/219. In situ repair of a secondary aortoappendiceal fistula with a rifampin-bonded Dacron graft.Secondary aortoenteric fistulas remain challenging diagnostic and therapeutic problems. Although the duodenum is most frequently involved, other intestinal segments are possible sites for fistulization. We report here a case of graft-appendiceal fistula revealed by recurrent gastrointestinal bleeding 11 years after abdominal aortic aneurysm replacement. The preoperative diagnosis was not achieved by endoscopy or imaging assessment. Despite recommended principles of total graft excision and extraanatomic bypass, appendectomy and in situ rifampin-bonded graft reconstruction were performed because of the advanced age and poor arterial runoff. The postoperative course was uneventful and the patient remains well 17 months after operation.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/219. 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 = 1keywords = aneurysm (Clic here for more details about this article) |
3/219. Post-traumatic pancreatitis with associated aneurysm of the splenic artery: report of 2 cases and review of the literature.In patients with acute pancreatitis, profuse gastrointestinal bleeding is associated with a high death rate. The cause of such bleeding must be evaluated and the bleeding controlled urgently. Aneurysm formation is usually the cause of the bleeding. angiography is needed to make a definitive diagnosis and the bleeding site should be controlled by angiographic embolization if possible. If this fails, aneurysm resection is necessary. Two patients are described. Both had aneurysms of the splenic artery, presenting as massive gastrointestinal bleeding in one patient and bleeding into an associated pseudocyst in the other. They required surgical repair, which was successful in both cases.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
4/219. Successful surgical treatment of primary aorto-duodenal fistula associated with inflammatory abdominal aortic aneurysm: A case report.We report a rare case of a 50-year-old woman with intermittent gastrointestinal (GI) bleeding and diagnosed as having primary aortoenteric fistula (PAEF) with inflammatory abdominal aortic aneurysm (IAAA). She was transferred to our institution with suspected PAEF as assessed by duodenoscopy and CT scan. As the patient was in shock due to massive GI-bleeding two days after admission, we performed an emergency laparotomy. The fistula was closed and the aneurysm replaced by a Woven Dacron Graft with an inter-positioning omental flap. A high index of suspicion is the most important diagnostic aid to prevent overlooking this often fatal disease.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
5/219. Acute dissecting thoracic aortic aneurysm presenting with stroke, consumptive coagulopathy, and gastrointestinal hemorrhage.We report the case of a 70-year-old man who had an acute dissection of a previously undiagnosed thoracic aortic aneurysm. The diagnosis was challenging because of the neurologic and hematologic complications that overwhelmed the clinical presentation. Three simultaneous complications of thoracic aortic aneurysm with dissection (ischemic stroke, consumption coagulopathy, and superior mesenteric infarction with gastrointestinal hemorrhage) made the case unique and the diagnosis difficult.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
6/219. Intractable oesophageal variceal bleeding caused by splenic arteriovenous fistula: treatment by transcatheter arterial embolization.We describe a rare case of splenic arteriovenous fistula and venous aneurysm which developed after splenectomy in a 40-year-old woman who presented with epigastralgia, watery diarrhoea, repeated haematemesis and melaena caused by hyperkinetic status of the portal system and bleeding of oesophageal varices. It was diagnosed by computed tomography and angiography, and obliterated with giant Gianturco steel coils.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
7/219. Two cases of aorto-gastrointestinal fistula.We report two cases of aorto-gastrointestinal fistula. Case 1, a 60-year-old man, suffered from repeat hematemesis. He was preoperatively diagnosed as aortoesophageal fistula with thoracic aortic aneurysm and was successfully treated by graft replacement of the aneurysm. Case 2, a 73-year-old man, presented with massive gastrointestinal bleeding, yet repeat endoscopical examination did not reveal the origin of the bleeding. He died of catastrophic hematochezia. The pathological findings at autopsy revealed an aortoduodenal fistula. These two cases suggested the importance to consider an aorto-gastrointestinal fistula in the differential diagnosis of patients presenting gastrointestinal hemorrhage.- - - - - - - - - - ranking = 2keywords = aneurysm (Clic here for more details about this article) |
8/219. hepatic artery aneurysm associated with upper gastrointestinal bleeding after intrahepatic artery chemotherapy.We present the course of illness of a 56 year-old patient with acute gastrointestinal bleeding after penetration of an aneurysm of the hepatic artery in the duodenal bulb. A diffuse intrahepatic metastasis of a carcinoid was treated with a loco-regional intraarterial chemotherapy via a catheter system implanted in the gastroduodenal artery. Five months after the catheter implantation melena occurred. The gastrointestinal arterial bleeding from the penetrating aneurysm presented a life-threatening situation. This cause of bleeding could not be brought under control endoscopically. Immediate surgical management became necessary.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
9/219. Intra-hepatic false aneurysm: a rare complication of ERCP.We report a rare case in which an intra-hepatic false aneurysm formed following endoscopic retrograde cholangiopancreatography and presented with life-threatening gastrointestinal bleeding. The aetiology, investigation and management of intra-hepatic false aneurysm is discussed.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
10/219. Primary aortoduodenal fistulas in minimally aneurysmal aortas: imaging diagnosis.We report on the utility of computed tomography (CT) in making the diagnosis of primary aortoduodenal fistulas in two cases presenting with massive gastrointestinal hemorrhage. In both cases, the clinical presentation was insidious, no pulsatile abdominal mass was palpated, and endoscopy findings were inconclusive. CT showed minimally aneurysmal aortas communicating with larger areas of contained rupture and pseudoaneurysm stretching adjacent small bowel.- - - - - - - - - - ranking = 11.565351886673keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
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