Abstract
Aortogastric fistulas are a rare type of aortoenteric fistula (AEF). Aortoenteric fistulas have been reported as a complication of endovascular aortic repair (EVAR) after the placement of prosthetic materials. Considering the anatomic relationship of the descending thoracic aorta and the stomach, the formation of an aortic fistula involving the stomach is an extremely rare case. We report the case of a 77-year-old woman who was admitted to the hospital due to severe mid-thoracic chest pain and was diagnosed with upper gastrointestinal bleeding. Her medical history included an aneurysm of the descending thoracic aorta, which was treated using the Thoracic Endovascular Repair (TEVAR) method several months prior. The patient died a few hours later amid hemorrhagic shock. The autopsy confirmed the upper gastrointestinal bleeding and revealed a fistula between the descending thoracic aorta and stomach, which were in anatomic contact because of a sliding hiatus hernia.
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References
Tagowski M, Vieweg H, Wissgott C, Andresen R. Aortoenteric fistula as a complication of open reconstruction and endovascular repair of abdominal aorta. Radiol Res Pract. 2014;2014:383159.
Davidovic LB, Spasic DS, Lotina SI, Kostic DM, Cinara IS, Svetkovic SD, et al. Aorto-entericne fistule. Srp Arh Celok Lek. 2001;129:183–93.
Bergqvist D, Björck M. Secondary arterioenteric fistulation-a systematic literature analysis. Eu J Vasc Endovasc Surg. 2009;37:31–42.
Wilson SE, Bennion RS, Serota AI, Williams RA. Bacteriological implications in the pathogenesis of secondary aorto-enteric fistulas. Br J Surg. 1982;69:545–8.
Chiba D, Hanabata N, Araki Y, Sawaya M, Yoshimura T, Aoki M, et al. Aortoesophageal fistula after thoracic endovascular aortic repair diagnosed and followed with endoscopy. Intern Med. 2013;52:451–5.
Chenu C, Marcheix B, Barcelo C, Rousseau H. Aorto-enteric fistula after endovascular abdominal aortic aneurysm repair: Case report and review. Eur J Vasc Endovasc Surg. 2009;37:401–6.
White GH, Yu W, May J. To the editors: “Endoleak”—A proposed new terminology to describe incomplete aneurysm exclusion by an endoluminal graft. J Endovasc Ther. 1996;3:124–5.
Sedivy P, Spacek M, El Samman K, Belohlavek O, Mach T, Jindrak V, et al. Endovascular treatment of infected aortic aneurysms. Eur J Vasc Endovasc Surg. 2012;44:385–94.
Kitamura T, Morota T, Motomura N, Ono M, Shibata K, Ueno K, et al. Management of infected grafts and aneurysms of the aorta. Ann Vasc Surg. 2005;19:335–42.
Ardolino A, Appleton SG. Aortogastric fistula secondary to pancreatitis. J R Soc Med. 2007;100:239–40.
Kielhofner MA, Schnell G, Schubert TT, Kebede-Daniels D. Aortogastric fistula from hiatal hernia ulcer. A cause of massive upper gastrointestinal bleeding. J Clin Gastroenterol. 1987;9:697–700.
Wasvary H, Wease G, Bierema T, Glover J. Gastro-aortic fistula: an uncommon complication of Nissen fundoplication. Am Surg. 1997;63:455–8.
Bégin LR, Sheiner NM. Anastomotic ulcer-induced aortoenteric fistula after esophago-gastroplasty. Ann Thorac Surg. 1992;54:564–5.
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TM and AM collected and analyzed the data, performed the literature search and selection and wrote the draft. VD and GN made substantial contributions to conception and design and revised the manuscript critically for important intellectual content. PS performed the autopsy, contributed to the conception and design of the study and finalized the draft. All authors read and approved the final manuscript.
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Maria, T., Maria, A., Dimitrios, V. et al. A rare case of sudden death due to aortogastric fistula after endovascular aortic repair of the descending aorta. Forensic Sci Med Pathol 17, 461–464 (2021). https://doi.org/10.1007/s12024-021-00374-0
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DOI: https://doi.org/10.1007/s12024-021-00374-0