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KMID : 0614620130610040230
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Korean Journal of Gastroenterology
2013 Volume.61 No. 4 p.230 ~ p.233
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A Case of Angiographic Embolization of Aortoenteric Fistula Caused by Endovascular Stent Grafting for an Abdominal Aortic Aneurysm
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Ko Kwang-Hun
Kim Seul-Young
Jung Il-Soon
Kim Kyu-Seop
Moon Hee-Seok
Sung Jae-Kyu
Jeong Hyun-Yong
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Abstract
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Aortoenteric fistula (AEF) developed after treatment for an abdominal aortic aneurysm (AAA) is a rare but usually fatal complication. We report a rare case of AEF bleeding after endovascular stent grafting for AAA which was managed angiographically. An 81-year-old man presented with hematochezia and acute abdominal pain for 1 day ago. Four years ago, an aortic stent was implanted in the infrarenal aorta for AAA. Endoscopies were performed to evaluate the hematochezia. Evidence of gastrointestinal bleeding was observed, but a clear bleeding point was not detected on upper endoscopy and colonoscopy. Contrast-enhanced computed tomography performed subsequently showed that the bleeding point was located in the fourth portion of the duodenum as an AEF caused by an inflammatory process in the stent-graft. Intra-arterial angiography showed a massive contrast leakage into the bowel via a small fistula from around the aortic stent graft site. Embolization was successfully performed by injecting a mixture of glue and lipiodol into the AEF tract. The patient was discharged with no evidence of gastrointestinal bleeding after the embolization. (Korean J Gastroenterol 2013;61:230-233)
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KEYWORD
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Aortoenteric fistula, Abdominal aortic aneurysm, Endovascular stent
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