Aortoenteric fistula- treatment option?
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Hello, my music teacher is a 47-year-old man. He is unwell with a 6-h history of massive fresh upper GI bleeding. He was a heavy smoker with no notable medical history. On examination, he had normal sensorium, pulse 113 beats/min, blood pressure 90/70 mmHg, and a cold sweaty skin. The laboratory investigations showed hemoglobin (Hb) 9.3 g/dL, white cell count 7100/mm3, while electrolytes, renal and coagulation profiles, serum amylase and liver function testes were normal. The abdominal examination was unremarkable except for tenderness in the epigastrium. After initial resuscitation, upper GI endoscopy was performed and showed a huge amount of fresh blood emanating from the duodenum. He has been diagnosed with aortoenteric fistula. What are all the treatment option, please advise.
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@ayan Aortoenteric fistulae (AEF) are defined as abnormal connections between the aorta or its major arterial branches and the GI tract in patients with or without previous aortic surgery. Patients with this diagnosis have a grim prognosis, and surgery is the only truly definitive management option. In today’s practice, with the majority of aneurysms repaired with endovascular stent grafts, familiarity with the treatment of graft infection is essential.
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