Vnitr Lek 2012, 58(6):490-493

The viewpoint of an internal medicine at the issue of an aortoenteric fistula

I. Šturdík^1,*, T. Koller¹, V. Šišovský², Ľ. Danihel², J. Payer¹

¹ V. interná klinika Lekárskej fakulty UK a UN Bratislava, Slovenská republika, prednosta prof. MUDr. Juraj Payer, CSc.

² Ústav patologickej anatómie Lekárskej fakulty UK a UN Bratislava, Slovenská republika, prednosta prof. MUDr. Ľudovít Danihel, PhD.

Aortoenteric fistula is an uncommon life-threatening disease; it can be divided into primary and secondary one. Primary aortoenteric fistula is the result of ongoing disease in the aorta and the intestine, secondary one is iatrogenic. Typical symptoms are abdominal pain and gastrointestinal bleeding (two-stage process). The most appropriate diagnostic method is CT aortography, treatment is only surgical. 75-year-old patient was admitted to the 5th Department of Internal Medicine in Bratislava due to progression of renal parameters, the patient had undergone an aortofemoral bypass 4 years ago. During the fourth day of his hospitalization the patient had a massive hematochezia with a shock state. After transient stabilization of the patient, 30 minutes after the first hematochezia, a massive hematemesis appeared and then the patient died. An autopsy has confirmed the secondary aortic-enteral fistula between the duodenum and the aneurysm arising from the aortofemoral bypass.

Keywords: aortoenteric fistula; hematemesis; melena; aortic aneurysm

Received: September 12, 2011; Accepted: February 13, 2012; Published: June 1, 2012  Show citation