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

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

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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