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March 17, 1962

Small-Bowel Erosion Following Aortic Resection

Author Affiliations

Ann Arbor, Mich.

From the Department of Surgery, The University of Michigan Medical School.

JAMA. 1962;179(11):882-886. doi:10.1001/jama.1962.03050110050010

Upper gastrointestinal hemorrhage occurring after resection of the abdominal aorta may be due to erosion of the duodenum by the aortic replacement or to an aorticoenteric fistula. The clinical findings frequently simulate those of peptic ulcer disease from which differentiation must be made early. Prompt surgical intervention is mandatory once the diagnosis is suspected. Twenty-eight of 40 patients previously reported in the literature failed to survive. Four additional patients are presented, all of whom died despite surgical intervention. These complications have occurred less frequently following the development and use of improved aortic prosthesis than they have following aortic replacement by homografts. Duodenal erosion by the prosthesis remains a hazard; the authors describe a technical maneuver which they have successfully employed in preventing this complication.