2.A Case of Angiographic Embolization of Aortoenteric Fistula Caused by Endovascular Stent Grafting for an Abdominal Aortic Aneurysm.
Kwang Hun KO ; Seul Young KIM ; Il Soon JUNG ; Kyu Seop KIM ; Hee Seok MOON ; Jae Kyu SEONG ; Hyun Yong JEONG
The Korean Journal of Gastroenterology 2013;61(4):230-233
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.
Aged, 80 and over
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Angiography
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Aortic Aneurysm, Abdominal/*therapy
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Aortic Diseases/*etiology/radiography/therapy
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Embolization, Therapeutic
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Endoscopy, Gastrointestinal
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Fistula/*etiology/radiography/therapy
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Gastrointestinal Hemorrhage/therapy
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Humans
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Male
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Stents/*adverse effects
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Tomography, X-Ray Computed