A Case of Angiographic Embolization of Aortoenteric Fistula Caused by Endovascular Stent Grafting for an Abdominal Aortic Aneurysm.
10.4166/kjg.2013.61.4.230
- Author:
Kwang Hun KO
1
;
Seul Young KIM
;
Il Soon JUNG
;
Kyu Seop KIM
;
Hee Seok MOON
;
Jae Kyu SEONG
;
Hyun Yong JEONG
Author Information
1. Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. mhs1357@hanmail.net
- Publication Type:Case Reports ; English Abstract
- Keywords:
Aortoenteric fistula;
Abdominal aortic aneurysm;
Endovascular stent
- MeSH:
Aged, 80 and over;
Angiography;
Aortic Aneurysm, Abdominal/*therapy;
Aortic Diseases/*etiology/radiography/therapy;
Embolization, Therapeutic;
Endoscopy, Gastrointestinal;
Fistula/*etiology/radiography/therapy;
Gastrointestinal Hemorrhage/therapy;
Humans;
Male;
Stents/*adverse effects;
Tomography, X-Ray Computed
- From:The Korean Journal of Gastroenterology
2013;61(4):230-233
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Aortoenteric fistula (AEF) developed after treatment for an abdominal aortic aneurysm (AAA) is a rare but usually fatal complication. We report a rare case of AEF bleeding after endovascular stent grafting for AAA which was managed angiographically. An 81-year-old man presented with hematochezia and acute abdominal pain for 1 day ago. Four years ago, an aortic stent was implanted in the infrarenal aorta for AAA. Endoscopies were performed to evaluate the hematochezia. Evidence of gastrointestinal bleeding was observed, but a clear bleeding point was not detected on upper endoscopy and colonoscopy. Contrast-enhanced computed tomography performed subsequently showed that the bleeding point was located in the fourth portion of the duodenum as an AEF caused by an inflammatory process in the stent-graft. Intra-arterial angiography showed a massive contrast leakage into the bowel via a small fistula from around the aortic stent graft site. Embolization was successfully performed by injecting a mixture of glue and lipiodol into the AEF tract. The patient was discharged with no evidence of gastrointestinal bleeding after the embolization.
