ABSTRACT
Primary aorto-enteric fistulas is now being a rare occurrence because of an aggressive approach in terms of surgery of abdominal aortic aneurysms. Three cases is presented in an attempt to elucidate the ethiology, pathogenesis and diagnostic possibilities when dealing with primary aorto-enteric fistulas. The clinical presentation of the patients with primary aorto-enteric fistulas is inconstant, but a hightened index of suspicion should be present when a patient presents with gastrointestinal bleeding of obscure origin, abdominal or back pain and an abdominal mass. Endoscopy and diagnostic imaging may detect a fistula, but a high rate of false negative investigations are produced. The result of diagnostic workup is often laparotomy, which is the safest diagnostic method and may save the patients life.
Subject(s)
Aortic Aneurysm/diagnosis , Aortic Diseases/diagnosis , Duodenal Diseases/diagnosis , Fistula/diagnosis , Intestinal Fistula/diagnosis , Adult , Aorta, Abdominal , Aortic Aneurysm/complications , Aortic Diseases/etiology , Aortic Diseases/surgery , Duodenal Diseases/etiology , Duodenal Diseases/surgery , Fistula/etiology , Fistula/surgery , Humans , Intestinal Fistula/etiology , Intestinal Fistula/surgery , Laparotomy , Male , Middle AgedABSTRACT
During a 4 1/2-years period sigmoideoscopy was performed when patients developed diarrhea and/or unexpected low abdominal pain within the first days following aortic reconstruction. In our investigation rigid sigmoideoscopy, revealed all the cases of major ischemic colitis.