Abstract
A 63-year-old patient had recurrent tarry stools and haemoglobin levels of around 7.0 g/dl. Ten years previously he had undergone an aortobifemoral bypass operation for peripheral vascular disease in the legs. Eight gastroscopies and five coloscopies over ten weeks failed to discover a bleeding source. Although an aortointestinal fistula was considered early on, extensive diagnostic tests failed to reveal it. Digital subtraction angiography was suggestive of an angiodysplasia of the terminal ileum, a diagnosis supported when coloscopy during exploratory laparotomy visualized blood trickling from the terminal ileum. As a result of this finding a right hemicolectomy was performed. But recurrent bleedings necessitated relaparotomy which finally revealed a fistula between the ascending duodenum and the proximal bypass graft anastomosis. Nine months after resection of the proximal anastomotic area and interposition of a Dacron prosthesis the patient has been free of symptoms.
| Translated title of the contribution | Aortointestinal fistula or angiodysplasia: A difficult differential diagnosis of gastrointestinal bleeding |
|---|---|
| Original language | German |
| Pages (from-to) | 57-62 |
| Number of pages | 6 |
| Journal | Deutsche Medizinische Wochenschrift |
| Volume | 118 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 1993 |
| Externally published | Yes |
ASJC Scopus subject areas
- General Medicine