Fatal Aortoduodenal Fistula Caused by a Ruptured Abdominal Aortic Aneurysm - a Case Report

Journal of Cardiovascular Emergencies

Russu Eliza¹  Kaller Réka¹  Arbănași Emil-Marian¹  Mureșan Adrian Vasile¹  Popa Daniel Gheorghe² 

[1] 1Clinic of Vascular Surgery, Emergency County Hospital, Târgu Mureș, Romania;2Department of Surgery, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, Târgu Mureș, Romania;

关键词: aortoduodenal fistula;    abdominal aortic aneurysm;    open repair;    hematemesis;    emergency;   

DOI  :  10.2478/jce-2021-0015

来源: DOAJ

【 摘 要 】

Introduction: Ruptured abdominal aortic aneurysm (AAA) has a high mortality, even when the patients reach the hospital in time and the intervention is expeditious. Case presentation: We present the case of a 66-year-old male patient, with a known history of AAA, presenting to the emergency room in a state of hypovolemic shock due to massive bleeding in the upper and lower gastrointestinal tract and acute abdominal pain, which presented an abrupt onset one hour before presentation. The computed tomography angiography identified an aortoduodenal fistula with a trajectory toward the D3 segment of the duodenum, as well as a common iliac artery occlusion and extensive atherosclerotic stigmas. The patient was rushed to the operation room where he was resuscitated with intravenous fluids, two units of packed red blood cells, and hemostatic agents. The bleeding was stopped by clamping the aorta above the aneurysm. The duodenum was sutured, and the aorta was reconstructed with an aortobifemoral graft. Unfortunately, even though intensive care procedures continued for a few hours after surgery, all therapeutic efforts failed and the patient had succumbed.

【 授权许可】

Unknown