Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal Aorta
The paper intends to present a review of imaging characteristics of secondary aortoenteric fistula (AEF). Mechanical injury, infection, and adherence of a bowel segment to the aorta or aortic graft are major etiologic factors of AEF after open aortic repair. The pathogenesis of AEF formation after e...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Radiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2014/383159 |
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| author | Marek Tagowski Hendryk Vieweg Christian Wissgott Reimer Andresen |
| author_facet | Marek Tagowski Hendryk Vieweg Christian Wissgott Reimer Andresen |
| author_sort | Marek Tagowski |
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| description | The paper intends to present a review of imaging characteristics of secondary aortoenteric fistula (AEF). Mechanical injury, infection, and adherence of a bowel segment to the aorta or aortic graft are major etiologic factors of AEF after open aortic repair. The pathogenesis of AEF formation after endovascular abdominal aortic repair is related to mechanical failure of the stent-graft, to stent graft infection, and to persistent pressurization of the aneurysmal sac. The major clinical manifestations of AEF comprise haematemesis, melaena, abdominal pain, sepsis, and fever. CT is the initial diagnostic modality of choice in a stable patient. However, the majority of reported CT appearances are not specific. In case of equivocal CT scans and clinical suspicion of AEF, scintigraphy, 67Ga citrate scans or 18F-FDG PET/CT is useful. Diagnostic accuracy of endoscopy in evaluation of AEF is low; nevertheless it allows to evaluate other than AEF etiologies of gastrointestinal bleeding. Without adequate therapy, AEF is lethal. Conventional surgical treatment is associated with high morbidity and mortality. The endovascular repair may be an option in hemodynamically unstable and high-risk surgical patients. We also illustrate an example of a secondary AEF with highly specific albeit rare radiologic picture from our institution. |
| format | Article |
| id | doaj-art-c9976fcb0abb49ffb875e9ae4d2d4882 |
| institution | Kabale University |
| issn | 2090-1941 2090-195X |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Radiology Research and Practice |
| spelling | doaj-art-c9976fcb0abb49ffb875e9ae4d2d48822025-02-03T01:10:43ZengWileyRadiology Research and Practice2090-19412090-195X2014-01-01201410.1155/2014/383159383159Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal AortaMarek Tagowski0Hendryk Vieweg1Christian Wissgott2Reimer Andresen3Institute of Diagnostic and Interventional Radiology and Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Esmarchstraße 50, 25746 Heide, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Esmarchstraße 50, 25746 Heide, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Esmarchstraße 50, 25746 Heide, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Esmarchstraße 50, 25746 Heide, GermanyThe paper intends to present a review of imaging characteristics of secondary aortoenteric fistula (AEF). Mechanical injury, infection, and adherence of a bowel segment to the aorta or aortic graft are major etiologic factors of AEF after open aortic repair. The pathogenesis of AEF formation after endovascular abdominal aortic repair is related to mechanical failure of the stent-graft, to stent graft infection, and to persistent pressurization of the aneurysmal sac. The major clinical manifestations of AEF comprise haematemesis, melaena, abdominal pain, sepsis, and fever. CT is the initial diagnostic modality of choice in a stable patient. However, the majority of reported CT appearances are not specific. In case of equivocal CT scans and clinical suspicion of AEF, scintigraphy, 67Ga citrate scans or 18F-FDG PET/CT is useful. Diagnostic accuracy of endoscopy in evaluation of AEF is low; nevertheless it allows to evaluate other than AEF etiologies of gastrointestinal bleeding. Without adequate therapy, AEF is lethal. Conventional surgical treatment is associated with high morbidity and mortality. The endovascular repair may be an option in hemodynamically unstable and high-risk surgical patients. We also illustrate an example of a secondary AEF with highly specific albeit rare radiologic picture from our institution.http://dx.doi.org/10.1155/2014/383159 |
| spellingShingle | Marek Tagowski Hendryk Vieweg Christian Wissgott Reimer Andresen Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal Aorta Radiology Research and Practice |
| title | Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal Aorta |
| title_full | Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal Aorta |
| title_fullStr | Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal Aorta |
| title_full_unstemmed | Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal Aorta |
| title_short | Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal Aorta |
| title_sort | aortoenteric fistula as a complication of open reconstruction and endovascular repair of abdominal aorta |
| url | http://dx.doi.org/10.1155/2014/383159 |
| work_keys_str_mv | AT marektagowski aortoentericfistulaasacomplicationofopenreconstructionandendovascularrepairofabdominalaorta AT hendrykvieweg aortoentericfistulaasacomplicationofopenreconstructionandendovascularrepairofabdominalaorta AT christianwissgott aortoentericfistulaasacomplicationofopenreconstructionandendovascularrepairofabdominalaorta AT reimerandresen aortoentericfistulaasacomplicationofopenreconstructionandendovascularrepairofabdominalaorta |