Surgical Approach for Duodenocaval Fistula Secondary to Inferior Vena Caval Graft Penetration

Abstract

Fistula formation between the duodenum and inferior vena cava (IVC) is a rare entity. It may be diagnosed after upper gastrointestinal bleeding. Here in, we present a case of IVC graft- duodenal fistula manifesting with hematemesis and melena which was diagnosed by upper gastrointestinal (GI) endoscopy. Abdominal computed tomography (CT) was reported as normal. At laparotomy, an IVC dacron graf with erosion into the adherent duodenum was explored. The graft was removed and the duodenum was repaired by doublelayer continuous suture with omental patch application. Surgery is the best therapeutic approach for treatment of dudodenocaval fistula. Double-layer continuous suture of duodenum supported by the application of an omental patch can be an option for surgical approach.

Keywords

• Inferior Vena Cava
• Graft Penetration
• Enteric Fistula

Vena Kava İnferior Greft Penetrasyonuna Sekonder Duodenokaval Fistullerde Cerrahi Yaklașım

Abstract

Duodenum ve inferior vena kava (İVK) arasında fistül olușumu nadir bir durumdur. Üst gastrointestinal kanamalardan sonra tanı konulabilir. Burada, hematemez ve melena ile belirti gösteren, üst gastrointestinal (Gİ) endoskopi ile tanı konulan İVK greft – duodenal fistül vakasını sunmaktayız. Abdominal bilgisayarlı tomografisi normal olarak rapor edildi. Laparotomide, İVK Dakron greft ile bitișiğindeki duodenumun erozyonu gözlendi. Greft çıkarıldı ve duodenum iki kat kontinü sütürle omental yama uygulanarak onarıldı. Cerrahi, duodenokaval fistülde en iyi tedavi yaklașımıdır. Duodenumun iki kat kontinü sütür ile omental yama desteği cerrahi yaklașımda bir seçenek olabilir.

Keywords

• İnferior Vena Kava
• Greft Penetrasyonu
• Enterik Fistül

References

1. 1. Guillem PG, Binot D, Dupuy-Cuny J, Laberenne JE, Lesage J, Triboulet JP et al. Duodenocaval fistula: A life-threatening condition of various origins. J Vasc Surg. 2001;33:643–645.
2. 2. Benjamin DS, Ruckle HC, Hadley HR. Local recurrence of renal cell carcinoma causing duodenal-inferior vena caval fistula: case report and review of the literature. Urology. 1996;48:636–638.
3. 3. Guo Y, Zhang YQ, Lin W. Radiologic diagnosis of duodenocaval fistula: a case report and literature review. World J Gastroenterol. 2010;16:2314–2316.
4. 4. Brandão D, Canedo A, Maia M, Ferreira J, Vaz G. Duodenocaval fistula as a result of a fish bone perforation. J Vasc Surg. 2010;51:1276–1278.
5. 5. Moran EA, Porterfield JR, Jr, Nagorney DM. Duodenocaval fistula after irradiation and resection of a retroperitoneal sarcoma. J Gastrointest Surg.2008;12:776–778.
6. 6. Chan SC, Fan ST, Lo CM, Liu CL, Wong J. Toward current standards of donor right hepatectomy for adult-to-adult live donor liver transplantation through the experience of 200 cases. Ann Surg. 2007;245:110–117.
7. 7. Perera GB, Wilson SE, Barie PS, Butler JA. Duodenocaval fistula: a late complication of retroperitoneal irradiation and vena cava replacement. Ann Vasc Surg. 2004;18:52–58.
8. 8. Rioux M, Lacourciere L, Langis P, Rouleau M. Sonographic detection of ingested foreign bodies in the inferior vena cava. Abdom Imaging. 1997;22:108– 110.

9. 9. Lesho EP, LeBrun C, Landry FJ, Tsuchida A, Cooper RH. Fatal duodenocaval fistula caused by peptic ulcer. South Med J. 1996;89:925–926.
10. 10. Miller CA, Melvin WS. Duodenocaval fistula complicating peptic ulcer disease: case report and review of the literature. Surgery. 1996;119:718–719.
11. 11. Christl SU, Scheppach W, Peters U, Kirchner T. Cerebral air embolism after gastroduodenoscopy: complication of a duodenocaval fistula. Gastrointest Endosc.1994;40:376–378.
12. 12. O'Keefe GE, Procyshyn AW. Duodenocaval fistulas. Can J Surg. 1992;35:347–349.
13. 13. Geraghty JG, Coveney E, Kennedy TE, O'Dwyer PJ, Murphy JJ. Duodenocaval fistula in peptic ulceration. Gut. 1991;32:452–453.
14. 14. Schwartz JT, Graham DY. Toothpick perforation of the intestines. Ann Surg.1977;185:64–66.
15. 15. Allen B, Krupski WC, Wylie EJ. Toothpick perforation of the inferior vena cava.West J Med. 1983;138:727–730.
16. 16. deSa LA, Roddie ME, Williamson RC. Fatal duodenocaval fistula resulting from a giant peptic ulcer. Acta Chir Scand.1990;156:647–650
17. 17. Scheppach W, Peters U, Kirchner T. Cerebral air embolism after gastroduodenoscopy: complication of a duodenocaval fistula. Gastrointest Endosc. 1994;40:376–378
18. 18. Hopper J, Browder W. Successful management of acute traumatic duodenocaval fistula. J Trauma. 1983;23:1015–1016.