Avtor/Urednik		Marolt, Urška; Potrč, Stojan; Bergauer, Andrej; Arslani, Nuhi; Papeš, Dino
Naslov		Aortoduodenal fistula three years after aortobifemoral bypass
Tip		članek
Vol. in št.		Letnik 52, št. 3
Leto izdaje		2013
Obseg		str. 363-368
ISSN		0353-9466 - Acta clinica Croatica
Jezik		eng
Abstrakt		Secondary aortoenteric fistulas (SAEF) are a relatively rare but dangerous complication of aortal reconstructive surgery. We present a patient that underwent aortobifemoral bypass three years before developing the signs of aortoenteric fistula, and we reviewed the literature on the topic. Since the clinical signs are nonspecific, physicians should have a high index of suspicion for SAEF in patients who underwent aortal reconstructive surgery. The most useful diagnostic tools for stable patients are upper gastrointestinal endoscopy and computed tomography scan with contrast that can, in combination with history and clinical signs, enable accurate diagnosis in more than 90% of patients. Unstable patients with suspected aortoenteric fistula should undergo exploratory laparotomy. The treatment of choice is open surgery with graft excision, wide debridement of infected tissue, bowel repair or resection followed by an extra-anatomic bypass or in situ placement of a new graft. Early postoperative mortality remains high, around 30% in most analyses. Currently there are no guidelines for the diagnosis and management of SAEF, so individualized approach is necessary for each patient.
Proste vsebinske oznake		aortoenteralna fistula gornji prebavni trakt krvavitev pooperativni zapleti aorto-bifemoralni obvod endovaskularni kirurški postopki