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An unusual cause of upper gastrointestinal bleeding.

Shahrokh S, Zali MR - Gastroenterol Hepatol Bed Bench (2014)

View Article: PubMed Central - PubMed

Affiliation: Gastroenterology and Liver Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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A 48-year-old man presented to our emergency department with hematemesis and abdominal pain... With suspicious to aortic aneurysm, CT-angiography was performed, which is shown in the picture below: CT-angio revealed two aneurysms on descending thoracic aorta, abdominal aorta and Aortoentric fistula between abdominal aneurysm and duodenum... TB and syphilis were ruled out... The patient recovered without complication... Aortoenteric fistula (AEF) a direct communication between the aorta and the gastrointestinal tract is an uncommon cause for acute upper gastrointestinal bleeding with high mortality rate if left untreated... The classic triad of massive gastrointestinal bleeding, a pulsatile abdominal mass, and abdominal (or back) pain is seen in small percentage of patients... A high index of suspicion is needed to establish the diagnosis of an aortoenteric fistula and should be considered in all patients with massive or repetitive upper gastrointestinal bleeding and a history of a thoracic or abdominal aortic aneurysm or a prosthetic vascular graft... The best diagnostic test is abdominal computed tomographic scanning, which often shows an aortic phlegmon in the area of the third or fourth portion of the duodenum... Aortography is typically unreliable and not recommended... Exploratory laparotomy is indicated for patients with suspected aortoenteric fistula and severe ongoing bleeding... Surgical repair of the aortic aneurysm and fistula is the standard treatment regardless of the cause... Therapy of an aortoenteric fistula due to an infected graft consists of intravenous antibiotics and emergency surgery.

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An unusual cause of upper gastrointestinal bleeding.

Shahrokh S, Zali MR - Gastroenterol Hepatol Bed Bench (2014)

© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129571&req=5

View Article: PubMed Central - PubMed

Affiliation: Gastroenterology and Liver Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

A 48-year-old man presented to our emergency department with hematemesis and abdominal pain... With suspicious to aortic aneurysm, CT-angiography was performed, which is shown in the picture below: CT-angio revealed two aneurysms on descending thoracic aorta, abdominal aorta and Aortoentric fistula between abdominal aneurysm and duodenum... TB and syphilis were ruled out... The patient recovered without complication... Aortoenteric fistula (AEF) a direct communication between the aorta and the gastrointestinal tract is an uncommon cause for acute upper gastrointestinal bleeding with high mortality rate if left untreated... The classic triad of massive gastrointestinal bleeding, a pulsatile abdominal mass, and abdominal (or back) pain is seen in small percentage of patients... A high index of suspicion is needed to establish the diagnosis of an aortoenteric fistula and should be considered in all patients with massive or repetitive upper gastrointestinal bleeding and a history of a thoracic or abdominal aortic aneurysm or a prosthetic vascular graft... The best diagnostic test is abdominal computed tomographic scanning, which often shows an aortic phlegmon in the area of the third or fourth portion of the duodenum... Aortography is typically unreliable and not recommended... Exploratory laparotomy is indicated for patients with suspected aortoenteric fistula and severe ongoing bleeding... Surgical repair of the aortic aneurysm and fistula is the standard treatment regardless of the cause... Therapy of an aortoenteric fistula due to an infected graft consists of intravenous antibiotics and emergency surgery.

No MeSH data available.