ABSTRACT
Aortoenteric fistula (AEF) is an uncommon but serious complication occurring after aortic surgery and may occur at any site in the gastrointestinal tract, with the duodenum being the most common. Conventional surgical repair of secondary AEF has high mortality, whereas endovascular repair has emerged as an alternative treatment despite concerns about persistent or recurrent infection. We report the case of a 91-year old man who was admitted with rectal bleeding from an aorto-appendiceal fistula 9 years after open abdominal aortic aneurysm repair. This rare site for AEF was diagnosed on computed tomography, and we present the first case of endovascular treatment of this uncommon complication.
Subject(s)
Aortic Diseases/surgery , Appendix , Cecal Diseases/surgery , Endovascular Procedures , Intestinal Fistula/surgery , Postoperative Complications , Vascular Fistula/surgery , Aged, 80 and over , Aortic Aneurysm, Abdominal/surgery , Aortic Diseases/diagnostic imaging , Aortic Diseases/etiology , Appendix/diagnostic imaging , Cecal Diseases/diagnostic imaging , Cecal Diseases/etiology , Humans , Intestinal Fistula/diagnostic imaging , Intestinal Fistula/etiology , Male , Radiography , Vascular Fistula/diagnostic imaging , Vascular Fistula/etiologyABSTRACT
BACKGROUND: Percutaneous endoscopic colostomy was used successfully to treat 3 patients with chronic intestinal pseudo-obstruction whose symptoms were not controlled by conservative measures. METHODS: Percutaneous endoscopic colostomy tubes were placed to allow intermittent decompression of the colon in response to the occurrence of symptoms. The technique and the equipment are the same as for PEG and are described herein. OBSERVATIONS: Symptom improvement was observed in 3 patients, and, to date, surgery has been avoided for all. CONCLUSIONS: Percutaneous endoscopic colostomy is a safe and effective management option for selected patients with chronic intestinal pseudo-obstruction.
