Abstract
BackgroundAortoenteric fistula (AEF) is a rare cause of gastrointestinal bleeding and is often misdiagnosed in clinical practice. Herein, a case series of AEFs are presented and the clinical characteristics, diagnosis, and management strategies are summarized.MethodsA retrospective analysis was performed on consecutive hospitalized patients with a final diagnosis of AEF at Beijing Friendship Hospital, Capital Medical University, between January 1, 2007 and March 31, 2020. The clinical data including diagnostic and management procedures as well as outcomes were collected and summarized.ResultsA total of nine patients were included in this study, five with primary AEF and four with secondary AEF. Eight of the patients were male, and the median age was 63 years. The fistulas were located in both the small intestine and the colon. All patients presented with gastrointestinal bleeding and pain, followed by weight loss, anorexia, and fever. A typical abdominal triad was found in only two cases. Seven patients experienced complications with preoperative abdominal infections and sepsis, and multiple organ failure occurred in four of these patients. All patients were assessed by computed tomography and five underwent abdominal and/or iliac aorta angiography. Two of these patients showed contrast agent leakage from the abdominal aorta into the intestine. Two cases were diagnosed with AEF by endoscopy before the operation. Eight patients received surgery and six patients survived.ConclusionsAEF is a rare cause of gastrointestinal bleeding that is associated with high mortality. Gastrointestinal bleeding and pain are the most common presentations. Timely diagnosis and multidisciplinary management are crucial to achieve a positive outcome.
Highlights
Aortoenteric fistula (AEF) is a rare cause of gastrointestinal bleeding and is often misdiagnosed in clinical practice
We reviewed all AEF patients admitted from Jan 2007 to March 2020 at a single institution, analyzed their clinical characteristics, methods used for their diagnosis, management modalities, and outcomes, to help clinicians better their recognition of this uncommon disease to improve its diagnosis and management
A total of nine patients with the final diagnosis of AEF were included in the analysis (Table 1)
Summary
Aortoenteric fistula (AEF) is a rare cause of gastrointestinal bleeding and is often misdiagnosed in clinical practice. A case series of AEFs are presented and the clinical characteristics, diagnosis, and management strategies are summarized. Aortoenteric fistulas (AEFs) are a rare cause of gastrointestinal bleeding [1]. They were first reported in the early nineteenth century and were defined as the presence of abnormal channels between the aorta and the gastrointestinal tract [2]. AEF is a complex and devastating clinical condition that leads to gastrointestinal bleeding and/ or severe sepsis, and it can be classified into two categories: primary aortoenteric fistula (PAEF), and secondary. Owing to the nonspecific and subtle clinical presentations, the diagnosis of AEF is difficult. We reviewed all AEF patients admitted from Jan 2007 to March 2020 at a single institution, analyzed their clinical characteristics, methods used for their diagnosis, management modalities, and outcomes, to help clinicians better their recognition of this uncommon disease to improve its diagnosis and management
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
