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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2002 Ottobre;43(5):711-4

lingua: Inglese

Primary aortoduodenal fistula including the afferent loop of a Billroth II anastomosis. A case report

Spinelli F., Mirenda F., Mandolfino T., La Spada M., Mondello B., D’Alfonso M., De Caridi G., Stilo F.

Depart­ment of Tho­racic and Car­di­o­vas­cular Sur­gery Uni­ver­sity of Mes­sina, Messina, ­Italy


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Pri­mary aor­toen­teric fis­tula is a ­very ­rare con­se­quence of the evo­lu­tion of an abdom­inal ­aortic aneu­rysm (AAA). The 3rd and ­4th por­tion of the duod­enum are ­involved in up to 80% of all ­cases. Fre­quently, gas­troin­tes­tinal ­bleeding rep­re­sents the ­first symp­tom, and diag­nosis is dif­fi­cult ­because of the aspe­cific clin­ical pres­en­ta­tion and ­course, char­ac­ter­ized by alter­nating remis­sion and ­relapse; ­this is the ­reason why sur­gical treat­ment is usu­ally ­delayed and there­fore ­such ­events are man­aged as emer­gen­cies ­with a pre­op­er­a­tive and intra­op­er­a­tive ­high ­death ­rate. We ­report the ­case of a 76-year-old man ­with a pri­mary aor­tod­u­od­enal fis­tula, who was sub­mitted to gas­tric resec­tion ­according to Bill­roth II 20 ­years ­before. ­This ­case ­could be inter­esting for its ana­tom­ical pecu­liar­ities favour­able to the for­ma­tion of the fis­tula.

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