ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Surgical approach to recurrent secondary aortoenteric fistulas: A case report
Elbrus Zarbaliyev1, Oğuz Konukoğlu2, Mehmet Çağlıkülekçi1, Denyan Mansuroğlu2, Serap Baş3, Hakan Kilercik4
1Department of General Surgery, Istanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital, Istanbul, Turkey
2Department of Cardiovascular Surgery, Istanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital, Istanbul, Turkey
3Department of Radiology, Istanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital, Istanbul, Turkey
4Department of Anesthesiology and Reanimation, Istanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital, Istanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2021.21518
The increasing number of abdominal aortic grafts due to abdominal aortic aneurysms has caused secondary aortoenteric fistulas to be seen more frequently as a cause of gastrointestinal bleeding. High index of suspicion plays a significant role in the diagnosis in patients having clinical symptoms ranging from fecal occult blood to massive gastrointestinal bleeding, accompanied by hemorrhagic shock. A 65-year-old male patient developed two secondary aortoenteric fistulas consecutively. The first one was aortic graft-jejunal and the second one was aortic graft-duodenal in a short period. Secondary aortoenteric fistula developed after aortobifemoral bypass. The patient underwent graft revision and jejunal repair. He was reoperated three months later due to the newly developed aortic graft-duodenal fistula. The duodenal defect was closed, and an extra-anatomic aortoiliac bypass was performed to avoid graft-related enteric fistula. The patient was discharged uneventfully and was free from any complication at nine months after surgery.
Keywords : Extra-anatomic reconstruction, graft-duodenal fistula, graft-jejunal fistula, recurrent graft enteric fistula, secondary aortoenteric fistula
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