PMID: 18720938Aug 30, 2008Paper

Primary aorto enteric fistula: report of 18 Belgian cases and literature review

Acta Gastro-enterologica Belgica
Ph DebonnairePh Van Hootegem

Abstract

We searched for Belgian cases of primary aorto enteric fistula (PAEF). After reviewing the literature we compared our data concerning incidence, types, pathogenesis, aetiology, clinical presentation, diagnostic modalities, treatment and prognosis of PAEF. We especially focus on the clinical picture and diagnostic options. We present our atypical case report. A questionnaire was send to 196 Belgian vascular surgeons in order to evaluate retrospectively the Belgian experience with PAEF. A Medline search of relevant literature from January 1980 to February 2006 was conducted. In total 18 Belgian cases of PAEF were detected usually originating from infrarenal abdominal aorta (83%), ending in the third or fourth part of the duodenum (67%) and affecting men (94%) with a mean age of 70-years-old. Main cause is aneurysm (89%). Gastrointestinal bleeding is the main symptom (83%). Untreated, no one survives and overall mortality is 29%. Most patients are treated with in situ grafts (83%). With our experience we propose a diagnostic flow chart to obtain early diagnosis of PAEF. PAEF is suspected when a patient presents with (considerable) (upper) gastrointestinal blood loss and has a known aneurysm, initial herald bleed or pulsating abdom...Continue Reading

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