SECONDARY AORTO-DUODENAL FISTULA. RECURRENT BLEEDING. DIFFICULTIES OF TOPICAL DIAGNOSIS AND TACTICAL ERRORS (CASE FROM CLINICAL PRACTICE)
The paper presents the case report of a secondary aorto-digestive fistula, which developed eight years after aortic prosthetics and was complicated by recurrent hemorrhage and anemia. The authors review the incidence of primary and secondary aorto-digestive fistulas, causes of their occurrence, localization variants, main clinical symptoms and methods of instrumental diagnostics. Various therapeutic and tactical approaches are discussed. With specific reference to the clinical case, the authors explain the complexity of topical diagnosis of the hemorrhage origin and treatment of this group of patients. Special attention is paid to therapeutic and tactical faults due to the lack of accurate information about the localization of aorto-digestive fistula. The complexity of the situation was also accounted for the effects of aortic prosthesis performed under retroperitoneal suppurative process. The article interprets the reasons for inadequate information value of MSCT-aortography and invasive aortography.
Panasyuk A.I., Kyshtymov S.A., Inozemcev E.O., Grigoryev E.G. 2020. Secondary aorto-duodenal fistula. Recurrent bleeding. Difficulties of topical diagnosis and tactical errors (case from clini-cal practice). Challenges in Modern Medicine, 43(1): 146–154 (in Russian). DOI
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