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Clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study
BACKGROUND: Upper gastrointestinal (GI) bleeding is the most important presentation of an aorto-duodenal fistula (ADF). Early diagnosis is difficult, and the disease is associated with high mortality. The present study aimed to examine the clinical and the endoscopic characteristics of ADF in eight...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851914/ https://www.ncbi.nlm.nih.gov/pubmed/33526013 http://dx.doi.org/10.1186/s12876-021-01616-9 |
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author | Ichita, Chikamasa Sasaki, Akiko Sumida, Chihiro Kimura, Karen Nishino, Takashi Tasaki, Junichi Masuda, Sakue Koizumi, Kazuya Kawachi, Jun Kako, Makoto |
author_facet | Ichita, Chikamasa Sasaki, Akiko Sumida, Chihiro Kimura, Karen Nishino, Takashi Tasaki, Junichi Masuda, Sakue Koizumi, Kazuya Kawachi, Jun Kako, Makoto |
author_sort | Ichita, Chikamasa |
collection | PubMed |
description | BACKGROUND: Upper gastrointestinal (GI) bleeding is the most important presentation of an aorto-duodenal fistula (ADF). Early diagnosis is difficult, and the disease is associated with high mortality. The present study aimed to examine the clinical and the endoscopic characteristics of ADF in eight patients who presented to our hospital. We also sought to clarify the diagnostic approach towards the disease. METHODS: The present study examined the clinical and the endoscopic/computed tomography (CT) characteristics of ADF in eight patients who were definitively diagnosed with this condition in a 12-year period at our hospital. RESULTS: The patients comprised of five men and three women, with a mean age of 69.8 years. Upper gastrointestinal bleeding was the chief complaint for all the patients. Out of these, two patients presented with shock. The patients’ mean haemoglobin at presentation was 7.09 g/dL, and the mean number of blood transfusions was 7.5. All patients had undergone intervention to manage an aortic pathology in the past. As the first investigation, an upper GI endoscopy in 5 and a CT scan in 3 patients were performed. In cases where CT scan was performed first, no definitive diagnosis was obtained, and the diagnosis was confirmed by performing an upper GI endoscopy. In cases where endoscopy was performed first, definitive diagnosis was made in only one case, and the other cases were confirmed by the CT scan. In some cases, tip attachments, converting to long endoscopes, and marking clips were found useful. CONCLUSIONS: In patients who have undergone intervention to manage an aortic pathology and have episodes of upper gastrointestinal bleeding, ADF cannot be definitively diagnosed with only one investigation. In addition, when performing upper GI endoscopy in cases where an ADF is suspected, tip attachment, converting to a long endoscope, and using marking clips can be helpful. |
format | Online Article Text |
id | pubmed-7851914 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-78519142021-02-03 Clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study Ichita, Chikamasa Sasaki, Akiko Sumida, Chihiro Kimura, Karen Nishino, Takashi Tasaki, Junichi Masuda, Sakue Koizumi, Kazuya Kawachi, Jun Kako, Makoto BMC Gastroenterol Research Article BACKGROUND: Upper gastrointestinal (GI) bleeding is the most important presentation of an aorto-duodenal fistula (ADF). Early diagnosis is difficult, and the disease is associated with high mortality. The present study aimed to examine the clinical and the endoscopic characteristics of ADF in eight patients who presented to our hospital. We also sought to clarify the diagnostic approach towards the disease. METHODS: The present study examined the clinical and the endoscopic/computed tomography (CT) characteristics of ADF in eight patients who were definitively diagnosed with this condition in a 12-year period at our hospital. RESULTS: The patients comprised of five men and three women, with a mean age of 69.8 years. Upper gastrointestinal bleeding was the chief complaint for all the patients. Out of these, two patients presented with shock. The patients’ mean haemoglobin at presentation was 7.09 g/dL, and the mean number of blood transfusions was 7.5. All patients had undergone intervention to manage an aortic pathology in the past. As the first investigation, an upper GI endoscopy in 5 and a CT scan in 3 patients were performed. In cases where CT scan was performed first, no definitive diagnosis was obtained, and the diagnosis was confirmed by performing an upper GI endoscopy. In cases where endoscopy was performed first, definitive diagnosis was made in only one case, and the other cases were confirmed by the CT scan. In some cases, tip attachments, converting to long endoscopes, and marking clips were found useful. CONCLUSIONS: In patients who have undergone intervention to manage an aortic pathology and have episodes of upper gastrointestinal bleeding, ADF cannot be definitively diagnosed with only one investigation. In addition, when performing upper GI endoscopy in cases where an ADF is suspected, tip attachment, converting to a long endoscope, and using marking clips can be helpful. BioMed Central 2021-02-01 /pmc/articles/PMC7851914/ /pubmed/33526013 http://dx.doi.org/10.1186/s12876-021-01616-9 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Ichita, Chikamasa Sasaki, Akiko Sumida, Chihiro Kimura, Karen Nishino, Takashi Tasaki, Junichi Masuda, Sakue Koizumi, Kazuya Kawachi, Jun Kako, Makoto Clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study |
title | Clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study |
title_full | Clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study |
title_fullStr | Clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study |
title_full_unstemmed | Clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study |
title_short | Clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study |
title_sort | clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851914/ https://www.ncbi.nlm.nih.gov/pubmed/33526013 http://dx.doi.org/10.1186/s12876-021-01616-9 |
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