Gastrointestinal Sistem Kanamalarının Nadir Bir Nedeni: Sekonder Aortoenterik Fistül

Yıl 2020, Cilt: 9 Sayı: 2, 65 - 68, 31.08.2020

Mustafa Erten Habib Sevimli Hatice Şeyma Akça Abdullah Algın Serdar Özdemir Serkan Emre Eroğlu

https://doi.org/10.47493/abantmedj.2020.12

Cited By: 1

Öz

Aortoenterik fistül, geçirilmiş aort cerrahisi varlığına göre primer ve sekonder olarak sınıflandırılır. Sekonder aortoenterik fistül, rekonstrüktif aorta cerrahisi sonrası gelişen, nadir görülen ve ölümcül gastrointestinal kanamalara neden olan bir komplikasyondur. Gastrointestinal kanama semptomlarıyla başvuran hastalarda alışılmış tanıların dışında kalan aortoenterik fistül tanısını koyabilmek için detaylı bir anamnez gerekir. Bu çalışmada, kanlı kusma ve karın ağrısı şikayetleri ile başvuran, 20 yıl önce geçirilmiş aorta cerrahisi öyküsü olan ve yapılan endoskopide kanama odağı saptanmayan, batın BT ve operasyon sonrasında aortoenterik fistül tanısı konulan 78 yaşında erkek hasta sunulmakta, patogenez ve tanı prosedürleri vurgulanmaktadır.

Anahtar Kelimeler

Gastrointestinal kanama, aort diseksiyonu, aortaenterik fistül

A Rare Cause of Gastrointestinal Hemorrhage: Secondary Aortoenteric Fistula

Öz

Aortoenteric fistula is classified as primary and secondary according to the presence of previous aortic surgery. Secondary aorto enteric fistula is a rare and fatal complication that develops after reconstructive aortic surgery. In patients presenting with gastrointestinal hemorrhage symptoms, a detailed anamnesis is required to diagnose aortoenteric fistula, which is outside the usual diagnoses. In this study, a 78-year-old male patient who presented with the complaints of bloody vomiting and abdominal pain, who had a history of aortic surgery 20 years ago and who had no bleeding focus at the endoscopy performed, was diagnosed with aortoenteric fistula after abdominal tomography and surgery, and pathogenesis and diagnostic procedures are emphasized.

Anahtar Kelimeler

Gastrointestinal hemorrhage, aortic dissection, aortoenteric fistula

Kaynakça

• Chang MW, Chan YL, Hsieh HC, Chang SS. Secondary aortoduodenal fistula. Chang Gung Med J. 2002;25(9):626-30
• Tuncer MM. Gastrointestinal Sistem Kanamaları. İçinde: Altıparmak MR, Hamuryudan V, Sonsuz A, Yazıcı H. Editör. Cerrahpaşa İç Hastalıkları 2. Baskı. İstanbul: İstanbul Tıp Kitapevi; 2012, s:1008.
• Yabu M, Himeno S, Kanayama Y, Furubayashi T, Kiriyama K, Nagasawa Y, Takakura R, Katata T, Iwao N, Orino A. Secondary aortoduodenal fistula Complicating aortic grafting, as a cause of intermittent chronic intestinal bleeding. Internal Medicine 1998;37(1):47-50.
• Bergqvist D. Arterioenteric fistula. Review of a vascular emergency. Acta Chir Scand1987;153(2):81-6.
• Estrada FP, Tachovsky TJ, Orr RM, Boylan JJ, Kram BW. Primary aortoduodenal Fistula following radiotherapy. SurgGynecolObstet1983;156(5):646–50.
• Peirce RM, Jenkins RH, Mac Enaeney P. Paraprosthetic extravasation of enteric contrast: a rare and direct sign of secondary aortoenteric fistula. AJR Am J Roentgenol. 2005; 184:73-4.
• Spanos K, Kouvelos G, Karathanos C, Matsagkas M, Giannoukas AD. Current status of endovascular treatment of aorto enteric fistula. Semin Vasc Surg 2017;30(2–3):80-4.
• Başer M, Arslantürk H, Kisli E, Arslan M, Oztürk T, Uygan I, Kotan C. Primary Aortoduodenal fistula due to a swalloweds ewing needle: a rare cause of Gastrointestinal bleeding. Ulus Travma Acil Cerrahi Derg 2007;13(2):154-7.
• Cho YP, Kang GH, Han MS, Jang HJ, Kim YH, Ryu JH, Park CK, Lee SG. Staged Surgery for chronic primary aortoduodenal fistula in a septic patient. J Korean Med Sci 2004;19(2):302-4.
• Wang FG, Huang QY, Yang YS. Primary aortoenteric fistula complicated by Esophageal ulcer: case report. Chin Med J 2004;117(4):635-6.
• Wood A, Bendjelid SM, Bendjelid K. Primary aortoenteric fistula: should enhanced Computed tomography be considered in the diagnostic work up. Anesth Analg. 2005; 101(4):1157-9.
• Ihama Y, Miyazaki T, Fuke C, Ihama Y, Matayoshi R, Kohatsu H, Kinjo F. An Autopsy case of a primary aortoenteric fistula: a pitfall of the endoscopic diagnosis. World J Gastroenterol 2008;14(29):4701-4.
• Vu QD, Menias CO, Bhalla S, Peterson C, Wang LL, Balfe DM, Aortoenteric fistulas: CT features and Potential mimics. Radiographics.2009;29(1):197-209.
• Champion MC, Sullivan SN, Coles JC, Goldbach M, Watson WC. Aortoenteric fistula. Incidence, presentation recognition, and management. Ann Surg 1982; 195(3):314-7.
• Biro G, Szabo G, Fehervari M, Munch Z, Szeberin Z, Acsady G. Late outcome Following open surgical management of secondary aortoenteric fistula. Langenbecks Arch Surg 2011;396(8):1221-9.
• Bissacco D, Freni L, Attisani L, Barbetta I, Dallatana R, Settembrini R. Unusual clinical presentation of primary aortoduodenal fistula. Gastroenterol Rep. 2015;3(2):170-4.
• Xiromeritis K, Dalainas I, Stamatakos M, Filis K. Aortoenteric fistulae: Present-Day management. Int Surg 2011;96(3):266-73.
• Sharif MA, Lee B, Lau LL, Ellis PK, Collins AJ, Blair PH, Soong CV. Prosthetic stent Graft infection after endovascular abdominal aortic aneurysm repair. J Vasc Surg 2007;46(3):442-8.
• Maternini M, Tozzi P, Vuilleumier H, VonSegesser LK. Intravascular ultrasound: One more tool to diagnose aortoduodenal fistula. Eur J Vasc Endovasc Surg 2006;32(5):542-4.
• Antoniou GA, Koutsias S, Antoniou SA, GeorgiakakisA, Lazarides MK, Giannoukas AD. Outcome after endovascular stent graft repair of aortoenteric fistula: A systematic review. J Vasc Surg 2009;49(3):782-9.
• Hohman D, Noghrehkar D, Sorensen V, Taylor E. Primary Aorto duodenal Fistula. The Internet Journal of Internal Medicine. 2008; 8:1-3.
• Šumskienė j, Šveikauskaitė E, Kondrackienė J, Kupčinskas L. Aorto-duodenal fistula: a rare but serious complication of gastrointestinal hemorrhage. A case reports. Acta Medica Lituanica, 2016;23(3):165-8.