Romatoid Artritli Hastada Primer Aortoduodenal Fistül

Year 2017, Volume: 7 Issue: 4, 175 - 177, 15.12.2017

Dilek Kuzukıran İsmail Sert Emre Turgut Yahya Capkis Fuat İpekci

Abstract

Primer aortoduodenal fistül (PADF), aort ve duodenum arasında anevrizma varlığında gelişir. Nadir bir durumdur, fakat yaşamı tehdit edici durumlara neden olur. Yaygın klinik sunumu gastrointestinal kanamadır. Ele gelen abdominal kitle ve abdominal ağrı diğer klinik semptomlardır. Günümüzde tanıda yaygın olarak intravenöz kontrastlı bilgisayarlı tomografi ve endoskopi kullanılmaktadır. Gastrointestinal kanamanın yaygın olmayan lokalizasyonu nedeniyle tanı koymak zor olabilir. Bu çalışmada, romatoid artritli hastada, akut mesenter iskemi ve morgagni hernisi kombinasyonunda PADF olgusu sunulmuştur.

Keywords

Aortoduodenal fistül, romatoid artrit, gastrointestinal kanama

Primary Aortoduodenal Fistula in Patients with Rheumatoid Arthritis

Abstract

Primary aortoduodenal fistula (PADF) develops between the aorta and duodenum in the presence of an aortic aneurysm. Although rare, it causes life-threatening conditions. A common clinical presentation is gastrointestinal bleeding. Palpable abdominal mass and abdominal pain are other clinical symptoms. Recently, computed tomography scan with intravenous contrast and endoscopy have been commonly used for diagnosis. Despite physical examination, endoscopy, and radiological evaluation, diagnosis can be challenging due to uncommon location of gastrointestinal bleeding. Here we present a case of PADF in combination with morgagni hernia and acute mesenteric ischemia in a patient with rheumatoid arthritis.

Keywords

Aortoduodenal fistula, rheumatoid arthritis, gastrointestinal bleeding

References

• 1. Lozano FS, Munos-Bellvis L, San Norberto E, Garcia-Plaza A, Gonzalez-Parras JR. Primary aortoduodenal fistula: new case reports and a reviw of the literature. J Gastrointest Surg 2008; 12: 1561-5. [CrossRef] 2. Voorhoeve R, Moll FL, de Letter JA, Bast TJ, Wester JP, Slee PH. Primary aortoenteric fistula: report of eight new cases and review of the literature. Ann Vasc Surg 1996; 10: 40-8. [CrossRef] 3. Shovmen O, Tiasano S, Comanester D, Cohen AD, Amital H, Sharf M. Aortic aneurysm associated with rhematoid arthritis: a population based cross-sectional study. Clin Rheumatol 2016; 35: 2657-61. [CrossRef] 4. Mizukami H, Hara S, Kobayashi M, Takahashi S, Mori S, Kuriiwa F, et al. Rupture of abdominal aneurysm associated with long term steroid therapy-A case report. Legal Med 2014; 16: 33-5. [CrossRef] 5. Sweeney MS, Gadacz TR. Primary aortoduodenal fistula: manifestation, diagnosis, and treatment. Surgery 1984; 96: 492-7. 6. van Olffen TB, Knippenberg LH, van der Vliet JA, Lastdrager WB. Primary aortoenteric fistula: report of six new cases. Cardiovasc Surg 2002; 10: 551-4. [CrossRef] 7. Korkut AK, Arpinar E, Yasar T, Guney D. Primary aortoduodenal fistula complicated by abdominal aortic aneurysm. J Cardiovasc Surg 2000; 41: 113-5. 8. Alzobydi AH, Guraya SS. Primary Aortoduodenal fistula; A case report. World J Gastroentrol 2013; 19: 415-7. [CrossRef] 9. Elliot JP, Smith RF, Szilagyi DE. Aortoenteric and paraprostheticenteric fistulas. Problems of diagnosis and management. Arch Surg 1974; 108: 479-90. [CrossRef] 10. Peck JJ, Eidemiller LR. Aortoenteric fistulas. Arch Surg 1992; 127: 1191-4. [CrossRef] 11. Vilos-Boas F, Azevedo F, Marques M, Baldaque-Silva F, Cardoso H, Costa-Lima J, et al. Primary aortoenteric fistula. Clin J Gastroenterol 2013; 6: 299-302.[CrossRef]