Primary aortoenteric fistula related to septic aortitis
Palavras-chave:
Aortite séptica, Fístula aortoenterica primária, Aneurisma, PseudoaneurismaResumo
CONTEXTO: Na maioria dos casos, as fistulas aortoentericas primárias resultam da erosão da parede do intestino por um aneurisma da aorta abdominal. Poucos pacientes foram descritos com etiologias distintas. OBJETIVO: O propósito desse trabalho é apresentar uma rara situação clínica, aortite séptica por Salmonella, que evoluiu para a formação de um pseudoaneurisma da aorta que perfurou a transição entre o duodeno e o jejuno. RELATO DE CASO: Uma paciente de 65 anos, diabética, foi admitida no hospital com bacteremia por Salmonella, que evoluiu para aortite séptica. Um mês após a alta hospitalar a paciente retornou apresentando psedoaneurisma da aorta abdominal infra-renal, que corroeu a transição entre o duodeno e o jejuno originando uma fístula aorto-entérica primária. Foi submetida ao tratamento cirúrgico, sendo realizada ligadura da aorta, remoção do hematoma infectado, enterectomia, êntero-êntero anastomose e enxerto extra-anatômico axilo-bifemoral com prótese de dacron. Na unidade de terapia intensiva a paciente apresentou parada cardiorrespiratória e óbito.
Downloads
Referências
Sweeney MS, Gadacz TR. Primary aortoduodenal fistula: manifestation, diagnosis, and treatment. Surgery 1984;96:492-7.
Perler BA, Ernst CB. Infected aneurysms. in: Veith FJ, Hobson RW, Williams RA, Wilson SE, editors. Vascular surgery: princi- ples and practice. New York: McGraw-Hill; 1994:589-608.
Voorhoeve R, Moll FL, Letter JAM, et al. Primary aortoenteric fistula: report of eight new cases and review of the literature. Ann Vasc Surg 1996;10:40-8.
Calligaro KD, Bergen WS, Savarese RP, et al. Primary aortoduodenal fistulae due to septic aortitis. J Cardiovasc Surg 1992;33:192-8.
Wheeler WE, Hanks J, Raman VK. Primary aortoenteric fistulas. Am Surg 1992;58:53-4.
McIntyre KE, Malone JM, Richards E, et al. Mycotic aortic pseudoaneurysm with aortoenteric fistula caused by Arizona hinshawii. Surgery 1982;91:173-7.
Goldbaum TS, Lindsay J Jr, Levy C, et al. Tuberculous aortitis presenting with an aortoduodenal fistula: a case report. Angiol- ogy 1986;37:519-23.
Morrow C, Safi H, Beall AC. Primary aortoduodenal fistula caused by Salmonella aortitis. J Vasc Surg 1987;6:415-8.
Oz MC, Brener BJ, Buda JA, et al. A ten-year experience with bacterial aortitis. J Vasc Surg 1989;10:439-49.
Voorhoeve R, Moll FL, Bast TJ. The primary aortoenteric fistula in the Netherlands: the unpublished cases. Eur J Vasc Endovasc Surg 1996;11:429-31.
Reckless JPD, McColl I, Taylor GW. Aortoenteric fistulae: an uncommon complication of abdominal aortic aneurysms. Br J Surg 1972;59:458-60.
Brenowitz JB, Williams CD. Successful repair of primary aortoduodenal fistula. Am Surg 1976;42:265-7.
Reiner MA, Brau AS, Schanzer H. Primary aortoduodenal fis- tula: case presentation and review of literature. Am J Gastroenterol. 1978;70:292-7.
Daugherty M, Shearer GR, Ernst CB. Primary aortoduodenal fistula: extra-anatomic vascular reconstruction not required for successful management. Surgery 1979;86:399-401.
Dossa CD, Pipinos I, Shepard AD, et al. Primary aortoenteric fistula. Ann Vasc Surg 1994;8:113-20.
Frizelle FA, Hung NA, Heslop JH, et al. Obscure gastrointestinal bleeding: idiopathic aortoduodenal fistula. J R Coll Surg Edinb 1991;36:331-3.
Goenka MK, Mehta SK, Kochhar R, et al. Primary aortoduodenal fistula in a 23-year-old man without an associated aortic aneurysm. Eur J Surg 1993;159:371-2.
Jaroch MT, Diehl JT, Zippert AM. Primary aortoduodenal fis- tula without abdominal aortic aneurysm. Cleve Clin Q 1985;52:579-81.
Stefles BC, O’Leary JP. Primary aortoduodenal fistula: a case report and review of the literature. Am Surg 1980;46:121-9.
Castilho Jr OT, Santos JS, Peres LC, et al. Fístula aortentérica primária. Rev Cir Vasc Angiol 1995;11:73-6.
Yegar RA, Taylor LM Jr, Moneta GL, Edwards JM, et al. Im- proved results with conventional management of infrarenal aor- tic infection. J Vasc Surgery 1999;30:76-83.
Svensson LG, Crawford ES. Aortic infections. In: Svensson LG, Crawford ES, editors. Cardiovascular and vascular disease of the aorta. Philadelphia: WB Saunders; 1997:126-52.
Walker WE, Cooley DA, Duncan JM, Hallman GL, Ott DA, Reul GJ. The management of aortoduodenal fistula by in situ replacement of the infected abdominal aortic graft. Ann Surg 1987;205:727-32.
Chan FY, Crawford ES, Coselli JS, et al. In situ prosthetic graft replacement for mycotic aneurysm of the aorta. Ann Thorac Surg 1989;47:193-203.
Torsello G, Sandman W, Geehrt A, et al. In situ replacement of infected vascular prosthesis with rifampin-soaked vascular grafts: early results. J Vasc Surg 1993;17:768-73.
Kieffer E, Bahnini A, Koskas F, Ruotolo C, Le Blevec D, Plissonnier D. In situ allograft replacement of infected infrarenal aortic prosthetic grafts: results in forty-three patients. J Vasc Surg 1993;17:349-56.
Claget GP, Valentine RJ, Hagino RT. Autogenous aortoiliac/ femoral reconstruction from superficial femoral-popliteal veins: feasibility and durability. J Vasc Surg 1997;25:255-70.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
