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New Computed Tomographic Signs of Aortoenteric Fistula

New Computed Tomographic Signs of Aortoenteric Fistula Abstract • Successful preoperative diagnosis of aortoenteric fistula is often difficult. Clinical findings, roentgenography, angiography, and endoscopy have been used in diagnosis with only partial success. Newer techniques of gallium citrate Ga 67 scanning, ultrasonography, and computed tomographic (CT) scanning have been used in recent years to establish the diagnosis of aortic graft infection or aortoenteric fistula. In two cases, the CT scan clearly established the diagnosis of secondary aortoenteric fistula, as well as two previously unreported signs of aortoenteric fistula: intraluminal aortic gas and paraprosthetic extravasation of contrast medium. (Arch Surg 1984;119:1073-1075) References 1. Haaga JR, Baldwin GN, Reich NE, et al: CT detection of infected synthetic grafts: Preliminary report of a new sign . AJR 1978;131:317-320.Crossref 2. Cunat JS, Haaga JR, Rhodes R, et al: Periaortic fluid aspiration for recognition of infected graft . AJR 1982;139:251-253.Crossref 3. Sergeant PT, Derom F: Aorto-enteric fistula as clinical entity . Acta Chir Belg 1978;3:187-194. 4. Thompson WM, Jackson DC, Johnsrude IS: Aortoenteric and paraprosthetic-enteric fistulas: Radiologic findings . AJR 1976;127:235-242.Crossref 5. Gregson R, Craig O: Aorto-enteric fistulae: The role of radiology . Clin Radiol 1983;34:65-72.Crossref 6. Busuttil RW, Rees W, Baker JD, et al: Pathogenesis of aortoduodenal fistula: Experimental and clinical correlates . Surgery 1979;85:1-13. 7. Perdue GD, Smith RB, Ansley JD, et al: Impending aortoenteric hemorrhage . Ann Surg 1980;192:237-243.Crossref 8. Kleinman LH, Towne JB, Bernhard VM: A diagnostic and therapeutic approach to aortoenteric fistulas: Clinical experience with 20 patients . Surgery 1979;86:868-880. 9. O'Mara CS, Williams GM, Ernst CB: Secondary aortoenteric fistula: A 20 year experience . Am J Surg 1981;142:203-209.Crossref 10. Jackson RS, Cremin BJ: Angiographic demonstration of gastrointestinal bleeding due to aorto-duodenal fistula . BrJ Radiol 1976;49:966-967.Crossref 11. Champion MC, Sullivan SN, Coles JC, et al: Aortoenteric fistula: Incidence, presentation, recognition, and management . Ann Surg 1981;195: 314-317.Crossref 12. Geary SR, Walworth EZ: Aortoduodenal fistula secondary to metastatic carcinoma . JAMA 1976;235:2520-2521.Crossref 13. Connolly JE, Kwaan JH, McCart PM, et al: Aortoenteric fistula . Ann Surg 1981;194:402-412.Crossref 14. Martin DW, Naughton JL, Smith LH: Aortoenteric fistula . West J Med 1981;134:242-247. 15. Gooding GA, Effeney DJ, Goldstone J: The aortofemoral graft: Detection and identification of healing complications by ultrasonography . Surgery 1981;89:94-101. 16. Causey DA, Fajman WA, Perdue GD, et al: 67Ga scintigraphy in postoperative synthetic graft infections . AJR 1980;134:1041-1045.Crossref 17. Baker MS, Fisher JH, van der Reis L, et al: The endoscopic diagnosis of an aortoduodenal fistula . Arch Surg 1976;111:304.Crossref 18. Baker BH, Baker MS: Diagnosis and treatment of aortoenteric fistulae: Case reports . Milit Med 1980;145:282-283. 19. Champion MC, Sullivan SN, Watson WC: Aortoduodenal fistula: Endoscopic diagnosis . Dig Dis Sci 1980;25:811-812.Crossref 20. Baker BH, Baker MS, van der Reis L, et al: Endoscopy in the diagnosis of aortoduodenal fistula . Gastrointest Endosc 1977;24:35-37.Crossref 21. Wilson SE, Bennion RS, Serota AI, et al: Bacteriological implications in the pathogenesis of secondary aortoenteric fistulas . Br J Surg 1982;69:545-548.Crossref 22. Rosenthal D, Deterling RA, O'Donnell TF, et al: Positive blood culture as an aid in the diagnosis of secondary aortoenteric fistula . Arch Surg 1979;114:1041-1044.Crossref 23. Criado FJ, Classen JN, Wilson TH: Secondary aorto-enteric fistulas: Prosthetic and paraprosthetic . Am J Surg 1981;47:313-321. 24. Lautin EM, Friedman AC: A complicated case of aortoduodenal fistula . Gastrointest Radiol 1979;4:401-404.Crossref 25. Pliskin M, Rogers WH: Diagnosis of aortic graft infection . Radiology 1979;133:798.Crossref 26. Puglia E, Fry PD: Aortoenteric fistulas: A preventable problem . Can J Surg 1980;23:74-76. 27. Mehta AI, McDowell DE, James EC: Treatment of massive gastrointestinal hemorrhage from aortoenteric fistula . Surg Gynecol Obstet 1978;146:59-62. 28. Dean RH, Allen TR, Foster JH, et al: Aortoduodenal fistula: An uncommon but correctable cause of upper gastrointestinal bleeding . Am Surg 1978;44:37-43. 29. Wierman WH, Strahan RW, Spencer JR: Small bowel erosion by synthetic aortic grafts . Am J Surg 1955;112:791-797.Crossref 30. Becker RM, Blundell PE: Infected aortic bifurcation grafts: Experience with 14 patients . Surgery 1976;80:544-549. 31. Florendo FT, Harmon HC: Aortoenteric fistula: A mandatory early operative diagnosis . South Med J 1979;72:1516-1518.Crossref 32. Ehrenfeld WK, Lord RSA, Stoney RJ, et al: Subcutaneous arterial bypass grafts in the management of fistulae between the bowel and plastic arterial prostheses . Ann Surg 1968;168:29-35.Crossref 33. Elliott JP, Smith RF, Szilagyi DE: Aortoenteric and paraprostheticenteric fistulas . Arch Surg 1974;108:479-490.Crossref 34. Garrett HE, Beall AC, Jordan GL, et al: Surgical considerations of massive gastrointestinal tract hemorrhage caused by aortoduodenal fistula . Am J Surg 1963;105:6-12.Crossref 35. Pinkerton JA: Aortoduodenal fistula . JAMA 1973;225:1196-1199.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

New Computed Tomographic Signs of Aortoenteric Fistula

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1984.01390210069015
Publisher site
See Article on Publisher Site

Abstract

Abstract • Successful preoperative diagnosis of aortoenteric fistula is often difficult. Clinical findings, roentgenography, angiography, and endoscopy have been used in diagnosis with only partial success. Newer techniques of gallium citrate Ga 67 scanning, ultrasonography, and computed tomographic (CT) scanning have been used in recent years to establish the diagnosis of aortic graft infection or aortoenteric fistula. In two cases, the CT scan clearly established the diagnosis of secondary aortoenteric fistula, as well as two previously unreported signs of aortoenteric fistula: intraluminal aortic gas and paraprosthetic extravasation of contrast medium. (Arch Surg 1984;119:1073-1075) References 1. Haaga JR, Baldwin GN, Reich NE, et al: CT detection of infected synthetic grafts: Preliminary report of a new sign . AJR 1978;131:317-320.Crossref 2. Cunat JS, Haaga JR, Rhodes R, et al: Periaortic fluid aspiration for recognition of infected graft . AJR 1982;139:251-253.Crossref 3. Sergeant PT, Derom F: Aorto-enteric fistula as clinical entity . Acta Chir Belg 1978;3:187-194. 4. Thompson WM, Jackson DC, Johnsrude IS: Aortoenteric and paraprosthetic-enteric fistulas: Radiologic findings . AJR 1976;127:235-242.Crossref 5. Gregson R, Craig O: Aorto-enteric fistulae: The role of radiology . Clin Radiol 1983;34:65-72.Crossref 6. Busuttil RW, Rees W, Baker JD, et al: Pathogenesis of aortoduodenal fistula: Experimental and clinical correlates . Surgery 1979;85:1-13. 7. Perdue GD, Smith RB, Ansley JD, et al: Impending aortoenteric hemorrhage . Ann Surg 1980;192:237-243.Crossref 8. Kleinman LH, Towne JB, Bernhard VM: A diagnostic and therapeutic approach to aortoenteric fistulas: Clinical experience with 20 patients . Surgery 1979;86:868-880. 9. O'Mara CS, Williams GM, Ernst CB: Secondary aortoenteric fistula: A 20 year experience . Am J Surg 1981;142:203-209.Crossref 10. Jackson RS, Cremin BJ: Angiographic demonstration of gastrointestinal bleeding due to aorto-duodenal fistula . BrJ Radiol 1976;49:966-967.Crossref 11. Champion MC, Sullivan SN, Coles JC, et al: Aortoenteric fistula: Incidence, presentation, recognition, and management . Ann Surg 1981;195: 314-317.Crossref 12. Geary SR, Walworth EZ: Aortoduodenal fistula secondary to metastatic carcinoma . JAMA 1976;235:2520-2521.Crossref 13. Connolly JE, Kwaan JH, McCart PM, et al: Aortoenteric fistula . Ann Surg 1981;194:402-412.Crossref 14. Martin DW, Naughton JL, Smith LH: Aortoenteric fistula . West J Med 1981;134:242-247. 15. Gooding GA, Effeney DJ, Goldstone J: The aortofemoral graft: Detection and identification of healing complications by ultrasonography . Surgery 1981;89:94-101. 16. Causey DA, Fajman WA, Perdue GD, et al: 67Ga scintigraphy in postoperative synthetic graft infections . AJR 1980;134:1041-1045.Crossref 17. Baker MS, Fisher JH, van der Reis L, et al: The endoscopic diagnosis of an aortoduodenal fistula . Arch Surg 1976;111:304.Crossref 18. Baker BH, Baker MS: Diagnosis and treatment of aortoenteric fistulae: Case reports . Milit Med 1980;145:282-283. 19. Champion MC, Sullivan SN, Watson WC: Aortoduodenal fistula: Endoscopic diagnosis . Dig Dis Sci 1980;25:811-812.Crossref 20. Baker BH, Baker MS, van der Reis L, et al: Endoscopy in the diagnosis of aortoduodenal fistula . Gastrointest Endosc 1977;24:35-37.Crossref 21. Wilson SE, Bennion RS, Serota AI, et al: Bacteriological implications in the pathogenesis of secondary aortoenteric fistulas . Br J Surg 1982;69:545-548.Crossref 22. Rosenthal D, Deterling RA, O'Donnell TF, et al: Positive blood culture as an aid in the diagnosis of secondary aortoenteric fistula . Arch Surg 1979;114:1041-1044.Crossref 23. Criado FJ, Classen JN, Wilson TH: Secondary aorto-enteric fistulas: Prosthetic and paraprosthetic . Am J Surg 1981;47:313-321. 24. Lautin EM, Friedman AC: A complicated case of aortoduodenal fistula . Gastrointest Radiol 1979;4:401-404.Crossref 25. Pliskin M, Rogers WH: Diagnosis of aortic graft infection . Radiology 1979;133:798.Crossref 26. Puglia E, Fry PD: Aortoenteric fistulas: A preventable problem . Can J Surg 1980;23:74-76. 27. Mehta AI, McDowell DE, James EC: Treatment of massive gastrointestinal hemorrhage from aortoenteric fistula . Surg Gynecol Obstet 1978;146:59-62. 28. Dean RH, Allen TR, Foster JH, et al: Aortoduodenal fistula: An uncommon but correctable cause of upper gastrointestinal bleeding . Am Surg 1978;44:37-43. 29. Wierman WH, Strahan RW, Spencer JR: Small bowel erosion by synthetic aortic grafts . Am J Surg 1955;112:791-797.Crossref 30. Becker RM, Blundell PE: Infected aortic bifurcation grafts: Experience with 14 patients . Surgery 1976;80:544-549. 31. Florendo FT, Harmon HC: Aortoenteric fistula: A mandatory early operative diagnosis . South Med J 1979;72:1516-1518.Crossref 32. Ehrenfeld WK, Lord RSA, Stoney RJ, et al: Subcutaneous arterial bypass grafts in the management of fistulae between the bowel and plastic arterial prostheses . Ann Surg 1968;168:29-35.Crossref 33. Elliott JP, Smith RF, Szilagyi DE: Aortoenteric and paraprostheticenteric fistulas . Arch Surg 1974;108:479-490.Crossref 34. Garrett HE, Beall AC, Jordan GL, et al: Surgical considerations of massive gastrointestinal tract hemorrhage caused by aortoduodenal fistula . Am J Surg 1963;105:6-12.Crossref 35. Pinkerton JA: Aortoduodenal fistula . JAMA 1973;225:1196-1199.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1984

References