Penetrating aortic ulcer with severe gastrointestinal bleeding

Zentralblatt für Chirurgie
B CertikF Slauf

Abstract

Primary aortointestinal fistula is a rare reason for gastrointestinal bleeding and mainly caused by a communication between the digestive tract and an aortic aneurysm. The penetrating aortic ulcer has been recently recognized as an independent pathological entity. It may penetrate through the aortic wall, leading to fistula into adjacent organs. We report the case of a 78-year-old woman who was admitted to our department with massive gastrointestinal hemorrhage. Endoscopy did not reveal the cause of hemorrhage. The diagnosis was made by computed tomography showing a primary aortoduodenal fistula without aortic aneurysm. The patient was successfully operated on. During urgent operation we found the penetrating atherosclerotic ulcer as the cause of the aortoduodenal communication. Primary aortoenteric fistula has a fatal outcome unless it is diagnosed accurately and urgently treated by surgical intervention. Contrast-enhanced computed tomography is the primary imaging modality to specify the diagnosis.

Citations

Jul 4, 2009·World Journal of Gastroenterology : WJG·Miklosh BalaAvraham-I Rivkind
Mar 14, 2007·Annals of Vascular Surgery·Andreas ThalheimerSiegfried Franke
Apr 6, 2021·Journal of Cardiovascular and Thoracic Research·Rahul DevDarbari Anshuman

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