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  • Title: Detection of an aortoenteric fistula in a patient with intermittent bleeding.
    Author: Odemiş B, Başar O, Ertuğrul I, Ibiş M, Yüksel I, Uçar E, Arda K.
    Journal: Nat Clin Pract Gastroenterol Hepatol; 2008 Apr; 5(4):226-30. PubMed ID: 18332903.
    Abstract:
    BACKGROUND: A 57-year-old male with an aortobifemoral bypass graft presented to a gastroenterology clinic with a 3-month history of intermittent hematemesis, melena and fever. The patient had received antibiotic therapy 2 months before for the same symptoms; however, following brief regression ( approximately 3 weeks) the symptoms had returned. INVESTIGATIONS: Physical examination; analysis of full blood count; measurement of erythrocyte sedimentation rate, C-reactive protein levels, liver enzymes, electrolytes, renal function, serum cholesterol and serum triglyceride; HIV serology; blood, sputum, urine and stool culture analysis; performance of esophagogastroduodenoscopy, colonoscopy, abdominal ultrasonography and multidetector CT scanning. DIAGNOSIS: Aortoenteric fistula with an inflammatory mass surrounding the aortobifemoral bypass graft. MANAGEMENT: Laparotomy with removal of the aortobifemoral bypass graft, performance of an extra-anatomic right axillofemoral bypass graft and an extra-anatomic right-left femorofemoral bypass graft.
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