CT Evaluation of Secondary Aortoduodenal Fistula: A Case Report

Seiji Itoh¹⁾, Keiichi Kubota¹⁾, Hiroaki Kogure⁴⁾, Naoki Satoh³⁾, Yoshimi Iwasaki¹⁾
Shinji Oka³⁾, Atsushi Sakuma¹⁾ and Masato Nemoto²⁾

¹⁾ 2nd Department of Surgery Dokkyo University School of Medicine, ²⁾ 2nd Department of Anesthsiology Dokkyo University School of Medicine, ³⁾ Department of Surgery, Kyowa Central Hospital, ⁴⁾ Department of Surgery, Utsunomiya Central Hospital

A secondary aortoenteric fistula directly communicates between the gastrointestinal tract and the aorta in patients undergoing major surgery on the aorta, often aortic graft replacement. In a case of secondary aortoduodenal fistula we treated, a 60-year-old man admitted due to repeated episodes of fever had undergone an aortic bypass graft 1 year and 10 months previously. Abdominal computed tomograpy (CT) showed the small pocket of gas in the graft. Endoscopy revealed a huge ulceration in the third portion of the duodenum. Extra anatomical revascularization between the right axillary and the bilateral femoral arteries was conducted first, removal of the old graft and partial resection of the duodenum. The postoperation course was uneventful. Two years and fifth months later, he remains a in excellent condition.

Key words
secondary aortoduodenal fistula, aortic bypass graft operation

Reprint requests
Seiji Itoh Second Department of Surgery, Dokkyo University School of Medicine Mibu, Tochigi, 321-0293 JAPAN

Accepted
March 28, 2001

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