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Aortoduodenal Fistula from Duodenal Stenting for Malignant Gastric Obstruction

Aortoduodenal fistula (ADF) is a rare cause of upper gastrointestinal (GI) bleeding and is usually fatal without intervention. A high index of suspicion is required to identify and successfully manage this condition. Three cases of ADF following duodenal stent insertion for gastric outflow obstructi...

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Bibliographic Details
Published in:EJVES vascular forum 2022-01, Vol.57, p.1-4
Main Authors: Bacopanos, Eleni, Jansen, Shirley, Hockley, Joe
Format: Article
Language:English
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Summary:Aortoduodenal fistula (ADF) is a rare cause of upper gastrointestinal (GI) bleeding and is usually fatal without intervention. A high index of suspicion is required to identify and successfully manage this condition. Three cases of ADF following duodenal stent insertion for gastric outflow obstruction secondary to metastatic adenocarcinoma are presented. All presented with upper GI bleeding and underwent emergency percutaneous endovascular aortic stent graft repair (EVAR), with temporary aortic balloon occlusion in one case. All were successful in achieving haemostasis. The first case, although initially complicated by acute stent thrombosis of the right iliac limb, was discharged to a rehabilitation facility and survived for two years. The second patient died two days after the procedure from sepsis related complications. The third was discharged home six days post-procedure with a three month follow up. A high suspicion for ADF in patients with previous duodenal stents is required for prompt diagnosis and management. EVAR may increase short to midterm life expectancy. •Aortoduodenal fistula following duodenal stent for malignant gastric obstruction•Cases underwent percutaneous endovascular stent graft repair and achieved haemostasis•In cases of ADF secondary to duodenal stenting, tube endografting may prolong life.
ISSN:2666-688X
2666-688X
DOI:10.1016/j.ejvsvf.2022.08.002