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2.
Rev. méd. Chile ; 149(1): 132-136, ene. 2021. ilus
Article Dans Espagnol | LILACS | ID: biblio-1389347

Résumé

Primary aortoenteric fistula is the spontaneous communication between the lumen of the aorta and a portion of the digestive tract. The most common cause is the erosion of an abdominal aortic aneurysm into the 3rd or 4th portion of the duodenum. It manifests clinically as gastrointestinal bleeding, with or without abdominal pain and a pulsatile abdominal mass on physical exam. Gastrointestinal bleeding is initially recurrent and self-limiting and progresses to fatal exsanguinating hemorrhage. Endoscopic examination diagnoses only 25% of aortoenteric fistulas because these are usually located in the distal duodenum. Contrast computed tomography of the abdomen and pelvis is diagnostic in only 60% of cases. We report three cases with this condition. A 67-year-old male presenting with an upper gastrointestinal bleeding. He was operated and a communication between an aortic aneurysm and the duodenum was found and surgically repaired. The patient is well. A 67-year-old male with an abdominal aortic aneurysm presenting with abdominal pain. He was operated and anticoagulated. In the postoperative period he had a massive gastrointestinal bleeding and a new CAT scan revealed an aorto enteric fistula that was surgically repaired. The patient is well. An 82-year-old male with an abdominal aortic aneurysm presenting with hematochezia. A CAT scan revealed a communication between the aneurysm and the third portion of the duodenum, that was surgically repaired. The patient died in the eighth postoperative day.


Sujets)
Humains , Mâle , Maladies de l'aorte , Rupture aortique , Fistule vasculaire/chirurgie , Fistule vasculaire/complications , Fistule vasculaire/imagerie diagnostique , Fistule intestinale/complications , Fistule intestinale/imagerie diagnostique , Anévrysme de l'aorte abdominale/chirurgie , Anévrysme de l'aorte abdominale/complications , Anévrysme de l'aorte abdominale/imagerie diagnostique , Maladies du duodénum/chirurgie , Maladies du duodénum/complications , Maladies du duodénum/imagerie diagnostique , Aorte abdominale , Duodénum , Hémorragie gastro-intestinale/étiologie
3.
Rev. chil. radiol ; 23(1): 20-24, 2017. ilus
Article Dans Espagnol | LILACS | ID: biblio-844631

Résumé

Biliary ileus, first described byThomas Bartholin in the year1654, is a rare cause of mechanical ileus (small bowel obstruction) (1-3% in patients younger than 65 years), increasing significantly from that age (25%). The necessarycondition forthis pathologyis the presence ofa fistula between the gallbladderandthe gastrointestinaltract. Simple abdominal X-ray and ultrasonography are widely available and of relatively low cost, together presenting a sensitivity of 74% when they show the classic signs of Rigler’s triad (pneumobilia, ectopic gallstone and dilated loops of small intestine), but computed tomography of the abdomen is considered the gold standard, with a sensitivity and specificity higher than 90%. The aim of this article is to present a case of radiological diagnosis of biliary ileus in a patient with vesicular lithiasis + cholecystoduodenal fistula, associated with inguinal hernia on the left.


El íleo biliar, descrito por primera vez por Thomas Bartholin en el año 1654, constituye una causa poco frecuente de íleo mecánico (1-3% en menores de 65 años) aumentando significativamente a partir de esa edad (25%). La condición necesaria para esta patología es la presencia de una fístula entre la vesícula biliar y el tracto gastrointestinal. La radiografía simple de abdomen y la ecografía son de amplia disponibilidad y coste relativamente bajo, presentando en conjunto una sensibilidad del 74% cuando manifiestan los signos clásicos de la tríada de Rigler (neumobilia, lito biliar ectópico y dilatación de asas de intestino delgado), pero se considera que la tomografía computada de abdomen es el gold standard, con una sensibilidad y especificidad superiores al 90%. El objetivo de este artículo es presentar un caso de diagnóstico radiológico de íleo biliar en un paciente con litiasis vesicular + fístula colecistoduodenal asociadas a hernia inguinal izquierda.


Sujets)
Humains , Mâle , Sujet âgé de 80 ans ou plus , Lithiase biliaire/complications , Lithiase biliaire/imagerie diagnostique , Hernie inguinale/complications , Hernie inguinale/imagerie diagnostique , Fistule intestinale/complications , Fistule intestinale/imagerie diagnostique , Abdomen aigu/étiologie , Iléus/imagerie diagnostique , Iléus/étiologie , Tomodensitométrie
4.
Rev. bras. cir. cardiovasc ; 31(3): 261-263, May.-June 2016. tab, graf
Article Dans Anglais | LILACS | ID: lil-796129

Résumé

ABSTRACT A 59 year-old patient was admitted with upper gastrointestinal bleeding. The clinical exam showed mild hypotension and blood samples revealed acute anemia (hemoglobin = 7.5 g/dl). Emergency computed tomography showed an infrarenal abdominal aortic aneurysm and extravasation of the arterial contrast material toward the digestive tract. The patient was transported to the operating room for emergency laparotomy, which showed an aortoduodenal fistula. After proximal and distal aortic vascular control, the two anatomical structures were dissected with duodenorrhaphy, patch repair of the aortic tear and omentum interposition. The postoperative recovery was uneventful, with discharge after 12 days.


Sujets)
Humains , Mâle , Adulte d'âge moyen , Maladies de l'aorte/chirurgie , Maladies de l'aorte/imagerie diagnostique , Fistule intestinale/chirurgie , Fistule intestinale/imagerie diagnostique , Maladies du duodénum/chirurgie , Maladies du duodénum/imagerie diagnostique , Aorte abdominale/chirurgie , Aorte abdominale/imagerie diagnostique , Tomodensitométrie , Fistule vasculaire/chirurgie , Fistule vasculaire/imagerie diagnostique , Anévrysme de l'aorte abdominale/chirurgie , Anévrysme de l'aorte abdominale/imagerie diagnostique , Hémorragie gastro-intestinale/chirurgie , Hémorragie gastro-intestinale/étiologie
6.
Article Dans Anglais | IMSEAR | ID: sea-124818

Résumé

A 65-year lady presented with diarrhea and weight loss of six months duration. Initial evaluation suggested that malabsorption was the possible underlying mechanism for the diarrhea. Work up for the common etiologies of malabsorption was non-contributory. Presence of pneumobilia raised the suspicion of a bilio-enteric fistula, which was subsequently confirmed on barium enema and endoscopic cholangio-pancreaticography to be a cholecystocolic fistula. At surgery, a fistulous tract from the fundus of the gallbladder was found to be communicating with the hepatic flexure. Fistulectomy with cholecystectomy resulted in prompt relief of symptoms. Cholecystocolic fistula (CCF) is a rare biliary fistula with diverse presentation.


Sujets)
Sujet âgé , Sulfate de baryum/diagnostic , Fistule biliaire/imagerie diagnostique , Maladies du côlon/imagerie diagnostique , Diagnostic différentiel , Diarrhée/étiologie , Lavement (produit) , Femelle , Humains , Fistule intestinale/imagerie diagnostique
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