Contemporary Management of Secondary Aortoduodenal Fistula

Annals of Vascular Surgery
Ryan HowardDawn M Coleman

Abstract

Secondary aortoduodenal fistula (SADF) is a rare, life-threatening complication of abdominal aortic reconstruction. Clinical presentation varies and treatment requires complex surgical repair associated with considerable morbidity and mortality. This retrospective study examines the contemporary management of SADF at a tertiary vascular surgical practice. Thirteen patients were managed for SADF between 2004 and 2014. Vascular and duodenal reconstructions were considered. Primary end points included bile leak, major complications, and mortality. Of the 13 patients presenting with SADF, 6 presented with luminal blood loss. During mean follow-up (632 days), the rate of major complication was 77%. Overall, 38% developed duodenal leak. All leaks occurred after graft explantation with extra-anatomic bypass, and the majority of these patients (80%) had no preceding history of acute gastrointestinal (GI) bleed. There were no leaks identified after duodenal exclusion with gastrojejunostomy. Patients that developed duodenal leak had longer mean intensive care unit length of stay (LOS; 7.0 vs. 2.3 days, P = 0.004), longer mean overall hospital LOS (36.6 vs. 18.5 days, P = 0.012), and greater late mortality (40% vs. 13%). There were 2 SADF...Continue Reading

References

Nov 1, 1993·Current Problems in Surgery·J A AsensioM D Kerstein
Nov 25, 2000·The British Journal of Surgery·E Degiannis, K Boffard
Dec 18, 2001·Journal of Vascular Surgery·J A BurksM L Marin
Oct 26, 2005·Journal of Vascular Surgery·Paul A ArmstrongDennis F Bandyk
Aug 8, 2006·Journal of Vascular Surgery·Donald T BarilMichael L Marin
Mar 18, 2008·Journal of Vascular and Interventional Radiology : JVIR·David BergqvistRickard Nyman
Nov 14, 2008·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·D Bergqvist, M Björck
Nov 26, 2008·Journal of Vascular Surgery·George A AntoniouAthanasios D Giannoukas
Feb 11, 2011·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·M J McCarthy

❮ Previous
Next ❯

Citations

Jun 28, 2016·The American Journal of Emergency Medicine·Robert C GesumariaAlan Lucerna
Nov 14, 2016·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·S K KakkosUNKNOWN Hellenic Co-operative Group on Aortic Surgery
Oct 22, 2017·BMJ Case Reports·Francesc Simó AlariAïcha Ahamdanech-Idrissi
Oct 20, 2018·Vascular and Endovascular Surgery·Corinna WalterJürgen Falkensammer
Oct 14, 2020·Vascular and Endovascular Surgery·Gaurang JoshiLewis B Schwartz
Apr 19, 2020·International Journal of Surgery Case Reports·Shinichiro MakimotoSatoshi Kuroyanagi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aneurysm

Aneurysms are outward distensions or bulges that occurs in a weakened wall of blood vessels. Discover the latest research on aneurysms here.

Aortic Aneurysm

An aortic aneurysm is the weakening and bulging of the blood vessel wall in the aorta. This causes dilatation of the aorta, which is usually asymptomatic but carries the risk of rupture and hemorrhage. Find the latest research on aortic aneurysms here.