Secondary late aortoenteric fistula associated with massive lower extremity abscess formation

In this presentation, we report a case of a 65-year-old man who underwent surgical treatment because of massive lower extremity abscess formation, which was related to an aortoentericfistula due to aortobifemoral bypass grafting.

📌 3 Key Takeaways

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Objective & Hypothesis:Aortoenteric fistulae are classified as primary or secondary.

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Key Findings & Data:Secondary aortoenteric fistulas arise between a graft and the gastrointestinal tract, after open surgical or endovascular aortic treatment, and have been reported in 0.4 to 4% of all aortic interventions.

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Conclusion & Impact:In this presentation, we report a case of a 65-year-old man who underwent surgical treatment because of massive lower extremity abscess formation, which was related to an aortoentericfistula due to aortobifemoral bypass grafting.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Aortoenteric fistulae are classified as primary or secondary. Primary aortoenteric fistulae arise between the native aorta and the gastrointestinal tract and are due to an atherosclerotic or mycotic aortic aneurysms eroding into the bowel lumen. Secondary aortoenteric fistulas arise between a graft and the gastrointestinal tract, after open surgical or endovascular aortic treatment, and have been reported in 0.4 to 4% of all aortic interventions. Because of the nonspesific nature of the clinical history and physical findings, diagnosis of aortoenteric fistulae is difficult to make preoperatively. The most common clinical manifestation of the aortoenteric fistula is gastrointestinal bleeding. In addition to difficulties in diagnosing these complications, significant mortality and morbidity despite of advanced treatment modalities are still challenging for surgeons. In this presentation, we report a case of a 65-year-old man who underwent surgical treatment because of massive lower extremity abscess formation, which was related to an aortoentericfistula due to aortobifemoral bypass grafting.

Özet

Aortoenterik fistüller, primer ve sekonder olmak üzere iki gruba ayrılır. Primer aortoenterik fistüller, nativ aorta ile gastrointestinal sistem arasında aterosklerotik veya mikotik aortik anevrizmanın barsak lümenini aşındırmasına bağlı oluşan fistülleri içerir. Sekonder aortoenterik fistüller ise açık cerrahi girişimler veya endovasküler aortik tedaviler sonrasında greft ile gastrointestinal sistem arasındaki fistüllerdir ve aortik girişimlerden sonra %0,4-4 oranında bildirilmiştir. Klinik öykü ve muayene bulgularının nonspesifik olmasından dolayı, aortoenterik fistüllerin preoperatif tanıları oldukça zordur. Aortoenterik fistüller klinikte karşımıza çoğunlukla gastrointestinal kanamayla ortaya çıkarlar. Tanı konulmasında karşılaşılan güçlüklerin yanı sıra, cerrahi olarak üstesinden gelinmesi zor, mortalite ve morbiditesi yüksek komplikasyonlardır. Bu sunuda 4 yıl önce geçirilmiş aortobifemoral bypass operasyonunun komplikasyonu olarak gelişen aortoenterik fistüle bağlı alt ekstremitede yaygın apse formasyonu ile kliniğimize başvurmuş olan sekonder aortoenterik fistüllü 65 yaşındaki erkek olgu sunuldu.

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Cite This Article

ERİŞ, C., YAVUZ, Ş., ERDOLU, B., AY, D., GÜCÜ, A., YÜMÜN, G., AKGÜL, E., TOKTAŞ, F. (2022). Secondary late aortoenteric fistula associated with massive lower extremity abscess formation. Damar Cerrahi Dergisi, Cilt: 22 - Sayı: 2, 238–241. https://ajindex.com/articles/486179

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