A RARE CASE OF PRIMARY AORTOENTERIC AND AORTOCAVAL FISTULA IN A PATIENT WITH ABDOMINAL AORTIC ANEURYSM
Abstract:
Primary aortoenteric fistula is an extremely rare, but life-threatening clinical condition. Herein, we report the case of aortosigmoid and aortocaval fistulas in a patient with a history of abdominal aortic aneurysm. A 68-year-old man was admitted to the Emergency Department with a one-day history of rectal bleeding and syncope. There was a high suspicion of aortoenteric fistula with active bleeding. Therefore a computed tomography (CT) scan of the abdomen with intravenous contrast was performed and revealed a large abdominal aneurysm of the aorta (63/36/120 mm) between the infrarenal aorta and the emergence of the right common iliac artery. The thrombosed portion of the aneurysm presented a fistula towards the superior rectum. The patient was brought to the operating room where excision of the aortorectal fistula, aortic closure, and Hartmann I resection were performed. In the following days, the patient had a complicated clinical evolution and died four days later.
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