ABSTRACT
Aortocaval fistula is a rare complication of abdominal aortic aneurysm, involving less than 1% of all abdominal aortic aneurysms. A 64-years old man with a long history of hypertension and abdominal aortic aneurysm had chest pain, dyspnea, epigastric discomfort and palpable abdominal pulsating mass. Physical examination revealed hypotension with a systolic blood pressure of 70 mmHg, a large pulsatile mass and a systolic abdominal bruit. Laboratory data revealed a hemoglobin values of 11.0 g/dL, blood urea nitrogen (BUN) value of 5 mg/dL, and creatine value of 2.6 mg%. Abdominal Angio CT showed a 10 cm infrarenal abdominal aortic aneurysm with dilatation of the IVC and aortocaval fistula from the aortic aneurysm, which was confirmed at emergency surgery. When the aneurysm was opened and the thrombus was removed, a 1 cm communication was identified between the aorta and IVC. This was controlled with Foley catheters ballooning, and the fistula was closed by continuous suture placed outside the aneurysm. A bifurcated aorto-iliac graft was used to restore arterial continuity. The patient was discharged home after uncomplicated postoperative course.
Subject(s)
Humans , Middle Aged , Aneurysm , Aorta , Aortic Aneurysm , Aortic Aneurysm, Abdominal , Blood Pressure , Blood Urea Nitrogen , Catheters , Chest Pain , Creatine , Dilatation , Dyspnea , Emergencies , Fistula , Hypertension , Hypotension , Physical Examination , Sutures , Thrombosis , Transplants , Vena Cava, InferiorABSTRACT
Aorto-gastric fistulas are relatively rare. Fistula formation between the aorta and the gartrointestinal tract is a serious condition that results in severe hemorrhage with a very high mortality rate. We present an unusual case of successful surgical treatment in Chonnam national university hospital ; of a patient with a aortogastric fistula into thoracoabdominal aortic aneurysm.
Subject(s)
Humans , Aorta , Aortic Aneurysm, Thoracic , Fistula , Hemorrhage , MortalityABSTRACT
Few patients with traumatic aortic laceration remain undiagnosed and survive long enough to develop a chronic aneurysm. Such aneurysms are frequently asymptomatic: alternatively, they may manifest chest pain, dysphagia, bronchial irritation, or sudden death. A case of aortobronchial fistula secondary to a chronic post-traumatic aneurysm of the aortic isthmus is presented. Hemoptysis was the main sign. The affected segment of the thoracic aorta was repaired with a Hemashield patch and a left upper lobectomy was performed.
Subject(s)
Humans , Aneurysm , Aorta, Thoracic , Chest Pain , Death, Sudden , Deglutition Disorders , Fistula , Hemoptysis , Lacerations , ThoraxABSTRACT
Tuberculosis of the esophagus is repoted to be very rare. Dysphagia and chest pain are the most common symptoms, but the massive hematemesis is less common. We had experienced a patient with esophagoaortic fistula caused by esophageal tuberculosis with massive hematemesis. A 42 year-old man who was urgently admitted with massive hematemesis. On admission an emergency endoscopy revealed a 0.7 cm sized rich vascularity granulomatous lesion on the 25 cm from the incisor , the patient underwent the wedge resection of the esophagus immediately. The esophagus was severely adhered to the aorta and the esophagealfistula to the aorta was presented. Double ligation was performed. On the 8th postoperative days the patient had massive bleeding through the mediastinal drainage and hematemesis after vomiting, he had performed explothoracotomy and died of the aortic rupture. We report the case with references of literature.
Subject(s)
Adult , Humans , Aorta , Aortic Rupture , Chest Pain , Deglutition Disorders , Drainage , Emergencies , Endoscopy , Esophageal Fistula , Esophagus , Fistula , Hematemesis , Hemorrhage , Incisor , Ligation , Tuberculosis , VomitingABSTRACT
Secondary aortoenteric fistula is a rare but fatal complication of reconstructive aortoiliac surgery. This disease entity could be divided into true aortoenteric fistula and paraprosthetic enteric fistula. The prevention, diagnosis and treatment of this complication remains a challenging problem. We report a 39 year old man who was diagnosed as paraprosthetic enteric fistula in endoscopy and operated 41 months after reconstructive aortoiliac surgery due to the infected pseudoaneurysm.