Korean Journal of Gastrointestinal Endoscopy 2004;29(6): 520-523.
원발성 대동맥-십이지장루 1예
윤성규ㆍ나병규ㆍ한군희ㆍ김영돈ㆍ황정원ㆍ홍현일ㆍ이승찬ㆍ김현승ㆍ장진근ㆍ천갑진
울산대학교 의과대학 강릉아산병원 내과학교실
A Case of Primary Aortoduodenal Fistula
Seong Gyu Yoon, M.D., Bung Kyu Na, M.D., Koon Hee Han, M.D., Young Don Kim, M.D., Jung Won Hwang, M.D., Hyun Il Hong, M.D., Seung Chan Lee, M.D., Hyoun Sung Kim, M.D., Jin Kun Jang, M.D. and Gab Jin Cheon, M.D.
Department of Internal Medicine, Gangneung Asan Medical Center, Ulsan University College of Medicine, Gangneung, Korea
Abstract
Aortoenteric fistula is a rare and life-threatening cause of upper gastrointestinal hemorrhage. Fistulas may be classified as primary or secondary. Secondary aortoenteric fistulas usually occur at the sA Case of Primary Aortoduodenal Fistulauture line following arterial reconstruction with prosthetic material and developed in 0.5∼2.4% of the patients. The incidence of primary fistulas was reported in 0.04∼0.07% in a large autopsy series and is 0.69∼2.36% in patients with abdominal aortic aneurysm. Atherosclerosis is now the dominant cause. The mortality rate of patients with primary aortoduodenal fistula (ADF) is extremely high, principally because the diagnosis is difficult and seldomly established before the massive bleeding results in emergency operation or death. This occurs predominantly in the third and fourth parts of the duodenum. Symptoms of ADF consist of flank pain or abdominal pain, hematemesis, melena, and an abdominal mass. ADF is curable, if diagnosed and treated with surgical intervention before the onset of lethal massive hemorrhage. We report a case of primary ADF with a review of the literatures. (Korean J Gastrointest Endosc 2004;29:520523)
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