A CASE OF AORTOENTERIC FISTULA

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  • 腹部大動脈瘤・空腸瘻の1例

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Abstract

Aortoenteric fistura in a special case of rupture of the abdominal aortic aneurysm. Rupture of the abdominal aortic aneurysm occurs at the third portion of the duodenum in most cases. The prognosis of the aortoenteric fistula in poor because io causes hematemesis, melana and sepsis. We report a rare case of aortoenteric fitula. A 67-year-old woman was seen at the hospital because of hematemesis and melena. In the abdomen, there was a pulsatile abdominal mass which measured was 7.0×7.0cm. Abdominal CT scan and angiography revealed an aortoenteric fistuula, and an emergency operation was performed. At laparotomy, the abdominal aortic aneurysm was seen below the left renal vein and was recognized to adhere to the jejunum strongly. The aortoenteric fistula was located at 5cm distal to the ligament of Treitz. Aneurysmectomy, partial resection of the duodenum and jejunum including the aortoenteric fistula, abdominal aortic replacement using a Y graft and doudenojejunostomy were performed. Her postoperative course was uneventful and there was no complications related to graft infection. Gastrointestinal series and angiography after the operation revealed no remarkable findings and she was discharged from the hospital on the 50 th postoperative day.

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