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Case series of aortoenteric fistulas: a rare cause of gastrointestinal bleeding

BACKGROUND: Aortoenteric 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. METHODS: A retrospective analysis was...

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Autores principales: Luo, Jia, Tang, Wen, Wang, Mengran, Xiao, Yao, Tan, Manhong, Jiang, Chunyan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856786/
https://www.ncbi.nlm.nih.gov/pubmed/33530944
http://dx.doi.org/10.1186/s12876-021-01629-4
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author Luo, Jia
Tang, Wen
Wang, Mengran
Xiao, Yao
Tan, Manhong
Jiang, Chunyan
author_facet Luo, Jia
Tang, Wen
Wang, Mengran
Xiao, Yao
Tan, Manhong
Jiang, Chunyan
author_sort Luo, Jia
collection PubMed
description BACKGROUND: Aortoenteric 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. METHODS: A 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. RESULTS: A 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. CONCLUSIONS: AEF 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.
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spelling pubmed-78567862021-02-04 Case series of aortoenteric fistulas: a rare cause of gastrointestinal bleeding Luo, Jia Tang, Wen Wang, Mengran Xiao, Yao Tan, Manhong Jiang, Chunyan BMC Gastroenterol Research Article BACKGROUND: Aortoenteric 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. METHODS: A 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. RESULTS: A 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. CONCLUSIONS: AEF 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. BioMed Central 2021-02-02 /pmc/articles/PMC7856786/ /pubmed/33530944 http://dx.doi.org/10.1186/s12876-021-01629-4 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
Luo, Jia
Tang, Wen
Wang, Mengran
Xiao, Yao
Tan, Manhong
Jiang, Chunyan
Case series of aortoenteric fistulas: a rare cause of gastrointestinal bleeding
title Case series of aortoenteric fistulas: a rare cause of gastrointestinal bleeding
title_full Case series of aortoenteric fistulas: a rare cause of gastrointestinal bleeding
title_fullStr Case series of aortoenteric fistulas: a rare cause of gastrointestinal bleeding
title_full_unstemmed Case series of aortoenteric fistulas: a rare cause of gastrointestinal bleeding
title_short Case series of aortoenteric fistulas: a rare cause of gastrointestinal bleeding
title_sort case series of aortoenteric fistulas: a rare cause of gastrointestinal bleeding
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856786/
https://www.ncbi.nlm.nih.gov/pubmed/33530944
http://dx.doi.org/10.1186/s12876-021-01629-4
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