1/16. Tuberculous infection of the descending thoracic and abdominal aorta: case report and literature review.We report here a case of infrarenal aortic disruption and aortoduodenal fistula secondary to tuberculous aortitis in a 77-year-old man. From a review of experience with operative management of tuberculous infection of the descending thoracic and abdominal aorta reported in the English-language literature, including the current report, we found that operative repair was attempted in 26 patients with tuberculous aortitis of the abdominal (n = 16), thoracic (n = 8), and thoracoabdominal (n = 2) aorta. Six patients had emergent operations for massive hemoptysis (n = 2), aortoduodenal fistula (n = 2), or abdominal rupture (n = 2), with an associated 30-day mortality of 50%. Elective or semi-elective repair was undertaken in 20 patients, of whom 19 (95%) survived for at least 30 days. On the basis of limited experience with this rare entity, in situ graft replacement is an appropriate treatment of tuberculous aneurysms and pseudoaneurysms of the descending thoracic and abdominal aorta.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
2/16. 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 = 3keywords = fistula (Clic here for more details about this article) |
3/16. Tuberculous aortitis with an aortoduodenal fistula presenting as recurrent gastrointestinal bleeding.Tuberculous aortitis with a tuberculous mycotic aneurysm and an aortoduodenal fistula was diagnosed in a 38-year-old man with tuberculous cervical lymphadentitis and a 3-month history of recurrent gastrointestinal bleeding, in whom extensive investigation of the digestive tract had not revealed a bleeding lesion. Either by septic embolism or by direct extension from a neighboring focus, tuberculous infection can cause a mycotic aortic aneurysm with subsequent fistulation to the duodenum.- - - - - - - - - - ranking = 3keywords = fistula (Clic here for more details about this article) |
4/16. Primary aortoenteric fistula related to septic aortitis.CONTEXT: Primary aortoenteric fistulas usually result from erosion of the bowel wall due to an associated abdominal aortic aneurysm. A few patients have been described with other etiologies such as pseudoaneurysm originating from septic aortitis caused by salmonella. OBJECTIVE: To present a rare clinical case of pseudoaneurysm caused by septic aortitis that evolved into an aortoenteric fistula. CASE REPORT: A 65-year-old woman was admitted with salmonella bacteremia that evolved to septic aortitis. An aortic pseudoaneurysm secondary to the aortitis had eroded the transition between duodenum and jejunum, and an aortoenteric fistula was formed. In the operating room, the affected aorta and intestinal area were excised and an intestine-to-intestine anastomosis was performed. The aorta was sutured and an axillofemoral bypass was carried out. In the intensive care unit, the patient had a cardiac arrest that evolved to death.- - - - - - - - - - ranking = 3.5keywords = fistula (Clic here for more details about this article) |
5/16. Inflammatory aortic aneurysm: a case report and review of literatures.A case of an uncommon variant of aortic aneurysm, inflammatory type, is reported. A 51-year-old Thai male presented with a pulsatile abdominal mass associated with pain. ultrasonography demonstrated infrarenal abdominal aortic aneurysm preoperatively and operative findings revealed dense fibrous tissue around the lesion. Serological tests for syphilis and bacteriological studies of aneurysm contents were all negative. Aneurysmorrhaphy was done, using Dacron straight graft, and two serious complications developed at six and two months interval: aortocolonic and aortoduodenal fistulae. However, the patient survived the three operations. Definite diagnosis of inflammatory aortic aneurysm was confirmed by typical pathological findings. Clinical presentations, operative and pathological findings were compared to previous literature.- - - - - - - - - - ranking = 0.5keywords = fistula (Clic here for more details about this article) |
6/16. Primary aortoduodenal fistula due to septic aortitis.We report the second case of a primary aortoenteric fistula resulting from septic aortitis with a contained aortic leak into the retroperitoneum and finally erosion into the duodenum. An emergency laparotomy revealed a fistula between the third part of the duodenum and a decompressed sac (false aneurysm) arising from a nonaneurysmal, grossly infected pararenal aorta. The purpose of this report is to present this rare case in detail and to review primary aortoenteric fistulas reported in the English language literature. Most fistulas form in association with an abdominal aortic aneurysm and rarely are due to infection. Only 6% of patients presented with the classic triad of abdominal pain, a palpable mass, and gastrointestinal bleeding. Although 29% of patients presented with massive hemorrhage, adequate time usually existed for surgical treatment of these complications. A patient with ill-defined abdominal pain and fever who suddenly develops a palpable abdominal mass should have an emergency ultrasound or CT scan to exclude the possibility of an infected aortic aneurysm or a contained rupture of an infected nonaneurysmal aorta. If the symptoms are associated with bleeding and the patient is hemodynamically stable, emergent endoscopy should also be performed. If a primary aortoenteric fistula or an aortic pseudoaneurysm is confirmed, emergent surgery should be undertaken to avoid rupture into the bowel or retroperitoneum.- - - - - - - - - - ranking = 4.5keywords = fistula (Clic here for more details about this article) |
7/16. rupture of a nonaneurysmal aorta secondary to Staphylococcus aortitis.Infectious aortitis has become increasingly uncommon and, when diagnosed, typically occurs in an immunocompromised elderly male with a history of Staphylococcus or salmonella infection and underlying atheromatous cardiovascular disease. The authors report a case of a 74-year-old man with aortitis complicated by rupture secondary to staphylococcus aureus infection. The patient presented with worsening abdominal pain and fever after being discharged from the emergency room 2 weeks before with back pain and leukocytosis diagnosed as urinary tract infection and bronchitis. Computed tomography (CT) imaging of the retroperitoneum on the first visit appeared normal. Repeat CT scan on the subsequent visit revealed a contained rupture of a nonaneurysmal aorta at the level of the diaphragm. The patient was taken to the operating room emergently for repair. An infected periaortic hematoma and a 1 cm perforation in the posterior aorta were found. The aorta was excised and the area debrided. Revascularization was performed using a 22 mm extruded polytetrafluoroethylene (ePTFE) interposition graft placed in situ. This case demonstrates that a high index of suspicion is required in diagnosing infectious aortitis and that the diagnosis may be delayed in many cases. Additionally, it may not be uncommon for the infected aorta to rupture without prior aneurysm formation.- - - - - - - - - - ranking = 0.0086422508594753keywords = urinary (Clic here for more details about this article) |
8/16. Surgical repair of primary aorto-jejunal fistula associated with non-specific inflammatory abdominal aortic aneurysm.A 28-year-old man with aorto-jejunal fistula associated with primary saccular abdominal aortic aneurysm (AAA) was effectively treated by resection and replacement with polytetraflouroethylene graft. The aetiology was suspected to be a non-specific aortitis, a rare cause of aorto-enteric fistula.- - - - - - - - - - ranking = 3keywords = fistula (Clic here for more details about this article) |
9/16. Inflammatory abdominal aortic aneurysm: a cause of urinary obstruction and acute renal failure.Abdominal aortic aneurysms are rare causes of ureteric obstruction. We report three cases of inflammatory abdominal aortic aneurysm producing hydronephrosis. In two patients acute renal failure preceded this presentation. The diagnosis can be established by computed tomography when mural thrombus, wall calcification, and an enhancing periaortic soft-tissue mantle are present. It is important to recognize this disease preoperatively.- - - - - - - - - - ranking = 0.034569003437901keywords = urinary (Clic here for more details about this article) |
10/16. Acute bacterial aortitis resulting in an aortoesophageal fistula. A fatal complication of untreated esophageal carcinoma.exsanguination in a case of esophageal carcinoma resulted from an aortoesophageal fistula. The squamous carcinoma was undiagnosed clinically and was untreated. Ulceration of the carcinoma gave rise to mediastinitis and an abscess containing necrotic tumor and bacteria. infection spread from the abscess to the adjacent aorta, producing focal bacterial aortitis, necrosis of the aortic media, and aortic perforation. A fistula was thus established between the aorta, the abscess cavity, and the esophagus. Terminally, the patient had a large hematemesis, and massive hemorrhage acutely distended the stomach which ruptured to produce a large hemoperitoneum.- - - - - - - - - - ranking = 3keywords = fistula (Clic here for more details about this article) |
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