Primary Aortoduodenal Fistula: Case Presentation and Review of Literature

MARK A. REINER, SALVADOR A. BRAU, HARRY SCHANZER

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18 Scopus citations

Abstract

One hundred and twelve cases of primary aortoduodenal fistulas were reviewed. The most common etiological agent was an atherosclerotic infrarenal abdominal aortic aneuiysm. There was a male to female predominance of 9:2 with an average age of 62 years. Most fistulas occurred between an infrarenal aneurysm and the third portion of tlie duodenum because of the relatively fixed position of the duodenum and its direct anatomical relationship posteriorly with the aorta. Patient symptoms may vary from abdominal or back pain with gastrointestinal bleeding to just hematemesis or melena. Twent)' per cent gave a history of abdominal aneurysm while up to 70% may have an abdominal mass on physieal examination at the time of admission. Tentative diagnosis is established by history and physical examination with duodcnoseopy, barium duodenogram and angiography availabk' only if temporall} feasible. Surgical exploration is the only treatment with resection of the aneurysm, synthetic graft placement and duodenal suturing as the procedure of choice.

Original languageEnglish
Pages (from-to)292-297
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume70
Issue number3
DOIs
StatePublished - Sep 1978

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