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Kenneth M. Mcdonald - One of the best experts on this subject based on the ideXlab platform.

  • Primary Aortoenteric Fistula Secondary to Ulcerative Atherosclerosis
    2016
    Co-Authors: Paul Frassinelli M. D, Mark A. Gittleman, Kenneth M. Mcdonald
    Abstract:

    Aortoenteric Fistulae after replacement surgery of the aorta is a well-described phenom-enon. Fewer than 200 cases of primary Aortoenteric Fistulae have, however, been reported. The vast majority of these reveal aortic or gastrointestinal pathology as etiolo-gies. The authors report on the very rare occurrence of primary Aortoenteric Fistula caused by ulcerative atherosclerosis in the absence of aortic aneurysm. The index of suspicion in patients with gastrointestinal bleeding of unknown etiology must be high to accurately diagnose an Aortoenteric Fistula. With aggressive testing and early laparotomy if indicated, the diagnosis of Aortoenteric Fistula can be ascertained and surgical correction can be accomplished

  • Primary Aortoenteric Fistula Secondary to Ulcerative Atherosclerosis A Case Report
    Vascular Surgery, 1995
    Co-Authors: Paul Frassinelli, Mark A. Gittleman, Kenneth M. Mcdonald
    Abstract:

    Aortoenteric Fistulae after replacement surgery of the aorta is a well-described phenom enon. Fewer than 200 cases of primary Aortoenteric Fistulae have, however, been reported. The vast majority of these reveal aortic or gastrointestinal pathology as etiolo gies. The authors report on the very rare occurrence of primary Aortoenteric Fistula caused by ulcerative atherosclerosis in the absence of aortic aneurysm.The index of suspicion in patients with gastrointestinal bleeding of unknown etiology must be high to accurately diagnose an Aortoenteric Fistula. With aggressive testing and early laparotomy if indicated, the diagnosis of Aortoenteric Fistula can be ascertained and surgical correction can be accomplished.

Lena Engellau - One of the best experts on this subject based on the ideXlab platform.

  • Aortoenteric Fistula caused by a ruptured stent-graft: a case report.
    Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery, 1998
    Co-Authors: Lars Norgren, Bengt Jernby, Lena Engellau
    Abstract:

    PURPOSE: To report a case of Aortoenteric Fistula secondary to endovascular abdominal aortic aneurysm (AAA) exclusion using the Stentor bifurcated endovascular graft. METHODS AND RESULTS: Seventeen months after a successful endovascular AAA procedure, a male patient developed upper gastrointestinal bleeding. An Aortoenteric Fistula was diagnosed. At operation, the endograft fabric was found to be ruptured in an area of suture disruption between the nitinol stents. Coincidentally, a pre-existing inflammatory process might have caused adhesions between the bowel and the aortic wall, predisposing to Fistula formation. The patient recovered after placement of a conventional aortic graft. CONCLUSIONS: Suture disruption between the internal support stents is a recognized complication in the first-generation Stentor device. Although the case described here is probably not typical of the consequences of this sequela, it does reinforce the need for continual periodic imaging to check for signs of graft disruption in Stentor endografts. (Less)

  • Aortoenteric Fistula Caused by a Ruptured Stent-Graft: A Case Report
    Journal of Endovascular Therapy, 1998
    Co-Authors: Lars Norgren, Bengt Jernby, Lena Engellau
    Abstract:

    Purpose: To report a case of Aortoenteric Fistula secondary to endovascular abdominal aortic aneurysm (AAA) exclusion using the Stentor bifurcated endovascular graft. Methods and Results: Seventeen months after a successful endovascular AAA procedure, a male patient developed upper gastrointestinal bleeding. An Aortoenteric Fistula was diagnosed. At operation, the endograft fabric was found to be ruptured in an area of suture disruption between the nitinol stents. Coincidentally, a pre-existing inflammatory process might have caused adhesions between the bowel and the aortic wall, predisposing to Fistula formation. The patient recovered after placement of a conventional aortic graft. Conclusions: Suture disruption between the internal support stents is a recognized complication in the first-generation Stentor device. Although the case described here is probably not typical of the consequences of this sequela, it does reinforce the need for continual periodic imaging to check for signs of graft disruption in Stentor endografts.

Bryan D. Petersen - One of the best experts on this subject based on the ideXlab platform.

  • Successful Endovascular Treatment of Aortoenteric Fistula Secondary to Eroding Duodenal Stent
    Journal of vascular and interventional radiology : JVIR, 2006
    Co-Authors: Peter T. Verhey, Andrew Best, Paul C. Lakin, James Nachiondo, Bryan D. Petersen
    Abstract:

    Aortoenteric Fistulas are characterized as either primary or secondary on the basis of their cause. Most Aortoenteric Fistulas occur between the aorta and duodenum and are a rare but well-known cause of catastrophic gastrointestinal hemorrhage. Conventional treatment of Aortoenteric Fistulas uses bypass grafting and aortic ligation, but endovascular treatments have become more common. The authors describe the successful endovascular repair of a primary Aortoenteric Fistula caused by eroding duodenal stent.

Lars Norgren - One of the best experts on this subject based on the ideXlab platform.

  • Aortoenteric Fistula caused by a ruptured stent-graft: a case report.
    Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery, 1998
    Co-Authors: Lars Norgren, Bengt Jernby, Lena Engellau
    Abstract:

    PURPOSE: To report a case of Aortoenteric Fistula secondary to endovascular abdominal aortic aneurysm (AAA) exclusion using the Stentor bifurcated endovascular graft. METHODS AND RESULTS: Seventeen months after a successful endovascular AAA procedure, a male patient developed upper gastrointestinal bleeding. An Aortoenteric Fistula was diagnosed. At operation, the endograft fabric was found to be ruptured in an area of suture disruption between the nitinol stents. Coincidentally, a pre-existing inflammatory process might have caused adhesions between the bowel and the aortic wall, predisposing to Fistula formation. The patient recovered after placement of a conventional aortic graft. CONCLUSIONS: Suture disruption between the internal support stents is a recognized complication in the first-generation Stentor device. Although the case described here is probably not typical of the consequences of this sequela, it does reinforce the need for continual periodic imaging to check for signs of graft disruption in Stentor endografts. (Less)

  • Aortoenteric Fistula Caused by a Ruptured Stent-Graft: A Case Report
    Journal of Endovascular Therapy, 1998
    Co-Authors: Lars Norgren, Bengt Jernby, Lena Engellau
    Abstract:

    Purpose: To report a case of Aortoenteric Fistula secondary to endovascular abdominal aortic aneurysm (AAA) exclusion using the Stentor bifurcated endovascular graft. Methods and Results: Seventeen months after a successful endovascular AAA procedure, a male patient developed upper gastrointestinal bleeding. An Aortoenteric Fistula was diagnosed. At operation, the endograft fabric was found to be ruptured in an area of suture disruption between the nitinol stents. Coincidentally, a pre-existing inflammatory process might have caused adhesions between the bowel and the aortic wall, predisposing to Fistula formation. The patient recovered after placement of a conventional aortic graft. Conclusions: Suture disruption between the internal support stents is a recognized complication in the first-generation Stentor device. Although the case described here is probably not typical of the consequences of this sequela, it does reinforce the need for continual periodic imaging to check for signs of graft disruption in Stentor endografts.

T.j. Bast - One of the best experts on this subject based on the ideXlab platform.

  • the primary Aortoenteric Fistula in the netherlands the unpublished cases
    European Journal of Vascular and Endovascular Surgery, 1996
    Co-Authors: R. Voorhoeve, Frans L. Moll, T.j. Bast
    Abstract:

    Objective: Primary Aortoenteric Fistula is a rare disorder of which only four patients have been reported in the Dutch literature so far. The objective of our study was to obtain more realistic figures on the incidence of this condition, with data on the clinical presentation, diagnostic procedures, treatment and results in a group of patients not previously reported as “case histories”. Methods: A questionnaire was sent to all surgical clinics in The Netherlands. Out of 180 questionnaires, 102 have been returned reporting 27 patients to which data of eight others treated in our own institution were added. Results: In all but one of these 29 patients the Fistula was caused by an atherosclerotic aneurysm, the one exception being caused by an ingested cocktail pin. Gastrointestinal haemorrhage was the predominant symptom, being present in 28 of the patients, while the complete triad of haemorrhage, pain and a pulsating mass was found in only eight patients. Twenty-seven patients were treated with an in situ graft of which 14 are doing well at long term follow-up. Conclusions: Primary Aortoenteric Fistula is far more common than one would expect from the number of patients reported in literature. A high index of suspicion based on a complete physical examination remains the key to a correct diagnosis. Direct closure of the intestine and in situ grafting of the aorta is the treatment of first choice.

  • The primary Aortoenteric Fistula in The Netherlands — the unpublished cases
    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 1996
    Co-Authors: R. Voorhoeve, Frans L. Moll, T.j. Bast
    Abstract:

    Objective: Primary Aortoenteric Fistula is a rare disorder of which only four patients have been reported in the Dutch literature so far. The objective of our study was to obtain more realistic figures on the incidence of this condition, with data on the clinical presentation, diagnostic procedures, treatment and results in a group of patients not previously reported as “case histories”. Methods: A questionnaire was sent to all surgical clinics in The Netherlands. Out of 180 questionnaires, 102 have been returned reporting 27 patients to which data of eight others treated in our own institution were added. Results: In all but one of these 29 patients the Fistula was caused by an atherosclerotic aneurysm, the one exception being caused by an ingested cocktail pin. Gastrointestinal haemorrhage was the predominant symptom, being present in 28 of the patients, while the complete triad of haemorrhage, pain and a pulsating mass was found in only eight patients. Twenty-seven patients were treated with an in situ graft of which 14 are doing well at long term follow-up. Conclusions: Primary Aortoenteric Fistula is far more common than one would expect from the number of patients reported in literature. A high index of suspicion based on a complete physical examination remains the key to a correct diagnosis. Direct closure of the intestine and in situ grafting of the aorta is the treatment of first choice.

  • Primary Aortoenteric Fistula: report of eight new cases and review of the literature.
    Annals of vascular surgery, 1996
    Co-Authors: R. Voorhoeve, Frans L. Moll, T.j. Bast, J.a.m. De Letter, J. P. J. Wester, P.h.th.j. Slee
    Abstract:

    Primary Aortoenteric Fistula, a direct communication between the aorta and the intestinal tract, is a rare cause of gastrointestinal hemorrhage. Eight patients who were all treated at one hospital are described, followed by a review of all surgically treated patients reported within the past 10 years. The usual cause is erosion of an atherosclerotic aneurysm into the adherent duodenum, but a wide variety of other causes and localizations have been described. The clinical presentation is usually one of intermittent gastrointestinal hemorrhage resulting in lethal exsanguination within a matter of hours or days. Pain, a pulsatile abdominal mass, or fever may or may not be present. Endoscopy, arteriography, ultrasound, and CT scan can be useful in the evaluation of these patients, but physical examination and a high index of suspicion remain key to diagnosis. Primary Aortoenteric Fistula is more often discovered unexpectedly during exploratory laparotomy and is not usually considered as a presumptive preoperative diagnosis. Although contamination is unavoidable, most patients are treated with an in situ vascular graft and primary closure of the intestinal defect with good results.