Two unique cases of primary aortoenteric fistula following a small aneurysm and penetrating ulcer of the abdominal aorta

Emmanouil Barmparessos; George Geropapas; Petros Chatzigakis; Vasileios Katsikas; George Kopadis

doi:10.1016/j.jvscit.2022.06.013

Two unique cases of primary aortoenteric fistula following a small aneurysm and penetrating ulcer of the abdominal aorta

J Vasc Surg Cases Innov Tech. 2022 Jul 16;8(3):450-454. doi: 10.1016/j.jvscit.2022.06.013. eCollection 2022 Sep.

Authors

Emmanouil Barmparessos¹, George Geropapas¹, Petros Chatzigakis¹, Vasileios Katsikas¹, George Kopadis¹

Affiliation

¹ Vascular Surgery Department, General Hospital of Athens "Georgios Gennimatas.", Athens, Greece.

Abstract

A primary aortoenteric fistula (PAEF) is a rare condition, and its associated mortality has remained high. We have presented two challenging cases of PAEF related to a small abdominal aortic aneurysm and an abdominal penetrating aortic ulcer. In both cases, a definite diagnosis was established intraoperatively, and the PAEF was repaired with in situ aortic reconstruction. Despite the successful outcome for the first patient, the postoperative complications were fatal for the second patient. The diagnosis of PAEF requires high suspicion and should be a part of the differential diagnosis in every case of gastrointestinal bleeding, especially when a history of, or risk factors for, aortic pathology are present.

Keywords: Abdominal aorta; Gastrointestinal bleeding; Penetrating aortic ulcer; Primary aortoenteric fistula; Small aneurysm.

Publication types

Case Reports