Aortoenteric fisulta: Difference between revisions
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==Background== | ==Background== | ||
A fistula formed between aorta and intestines, can be primary or secondary (often due to AAA repair) | |||
* Can form fistula anytime within life of AAA graft repair | |||
<big>Incidence</big>: The annual incidence of primary aortoenteric fistulas is estimated to be about 0.007 per million while secondary aortoenteric fistulas is about 0.6-2% | <big>Incidence</big>: The annual incidence of primary aortoenteric fistulas is estimated to be about 0.007 per million while secondary aortoenteric fistulas is about 0.6-2% | ||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 20:33, 25 March 2015
Background
A fistula formed between aorta and intestines, can be primary or secondary (often due to AAA repair)
- Can form fistula anytime within life of AAA graft repair
Incidence: The annual incidence of primary aortoenteric fistulas is estimated to be about 0.007 per million while secondary aortoenteric fistulas is about 0.6-2%
Clinical Features
- Classic triad of abdominal pain, GI bleeding and pulsatile abdominal mass only present in 23% of patients
- Low grade fever,
- abd pain,
- Back pain,
- h/o AAA graft
- BRBPR
Differential Diagnosis
Undifferentiated lower gastrointestinal bleeding
- Upper GI Bleeding
- Diverticular disease
- Vascular ectasia / angiodysplasia
- Inflammatory bowel disease
- Infectious colitis
- Mesenteric Ischemia / ischemic colitis
- Meckel's diverticulum
- Colorectal cancer / polyps
- Hemorrhoids
- Aortoenteric fistula
- Nearly 100% mortality if untreated
- Consider in patients with gastrointestinal bleeding and known abdominal aortic aneurysms or aortic grafts
- Rectal foreign body
- Rectal ulcer (HIV, Syphilis, STI)
- Anal fissure