Aortoduodenal Fistula from Duodenal Stenting for Malignant Gastric Obstruction
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作者:
Bacopanos, Eleni
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Sir Charles Gairdner Hosp, Dept Vasc & Endovascular Surg, Perth, WA, AustraliaSir Charles Gairdner Hosp, Dept Vasc & Endovascular Surg, Perth, WA, Australia
Bacopanos, Eleni
[1
]
Jansen, Shirley
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Sir Charles Gairdner Hosp, Dept Vasc & Endovascular Surg, Perth, WA, Australia
Curtin Univ, Curtin Med Sch, Perth, WA USA
Harry Perkins Med Res Inst, Heart & Vasc Res Inst, Perth, WA, Australia
Univ Western Australia, Perth, WA, AustraliaSir Charles Gairdner Hosp, Dept Vasc & Endovascular Surg, Perth, WA, Australia
Jansen, Shirley
[1
,2
,3
,4
]
Hockley, Joe
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Sir Charles Gairdner Hosp, Dept Vasc & Endovascular Surg, Perth, WA, Australia
Curtin Univ, Curtin Med Sch, Perth, WA USA
Harry Perkins Med Res Inst, Heart & Vasc Res Inst, Perth, WA, AustraliaSir Charles Gairdner Hosp, Dept Vasc & Endovascular Surg, Perth, WA, Australia
Hockley, Joe
[1
,2
,3
]
机构:
[1] Sir Charles Gairdner Hosp, Dept Vasc & Endovascular Surg, Perth, WA, Australia
[2] Curtin Univ, Curtin Med Sch, Perth, WA USA
[3] Harry Perkins Med Res Inst, Heart & Vasc Res Inst, Perth, WA, Australia
Introduction: Aortoduodenal fistula (ADF) is a rare cause of upper gastrointestinal (GI) bleeding and is usually fatal without intervention. A high index of suspicion is required to identify and successfully manage this condition. Report: Three cases of ADF following duodenal stent insertion for gastric outflow obstruction secondary to metastatic adenocarcinoma are presented. All presented with upper GI bleeding and underwent emergency percutaneous endovascular aortic stent graft repair (EVAR), with temporary aortic balloon occlusion in one case. All were successful in achieving haemostasis. The first case, although initially complicated by acute stent thrombosis of the right iliac limb, was discharged to a rehabilitation facility and survived for two years. The second patient died two days after the procedure from sepsis related complications. The third was discharged home six days post-procedure with a three month follow up. Conclusion: A high suspicion for ADF in patients with previous duodenal stents is required for prompt diagnosis and management. EVAR may increase short to midterm life expectancy.(c) 2022 The Authors. Published by Elsevier Ltd on behalf of European Society for Vascular Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Article history: Received 21 March 2022, Revised 11 August 2022, Accepted 24 August 2022, gastrointestinal bleeding
机构:
Brigham & Womens Hosp, Gastroenterol Hepatol & Endoscopy, Boston, MA 02115 USABrigham & Womens Hosp, Gastroenterol Hepatol & Endoscopy, Boston, MA 02115 USA
Ramai, Daryl
Nelson, Richard
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Univ Utah Hlth, Div Epidemiol, Salt Lake City, UT USA
IDEAS Ctr, VA Salt Lake City Med Ctr, Salt Lake City, UT USABrigham & Womens Hosp, Gastroenterol Hepatol & Endoscopy, Boston, MA 02115 USA
Nelson, Richard
Chaiyakunapruk, Nathorn
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IDEAS Ctr, VA Salt Lake City Med Ctr, Salt Lake City, UT USA
Univ Utah, Coll Pharm, Dept Pharmacotherapy, Salt Lake City, UT USABrigham & Womens Hosp, Gastroenterol Hepatol & Endoscopy, Boston, MA 02115 USA
Chaiyakunapruk, Nathorn
Ofosu, Andrew
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Univ Cincinnati, Gastroenterol & Hepatol, Cincinnati, OH USABrigham & Womens Hosp, Gastroenterol Hepatol & Endoscopy, Boston, MA 02115 USA
Ofosu, Andrew
Fang, John C.
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Univ Utah Hlth, Gastroenterol, Salt Lake City, UT USABrigham & Womens Hosp, Gastroenterol Hepatol & Endoscopy, Boston, MA 02115 USA