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January 1963

Complications of Abdominal Aortic Surgery: Part I: Aortoenteric Fistula

Author Affiliations

From the Department of Vascular Surgery and the Department of Peripheral Vascular Disease, Cleveland Clinic Foundation.

Arch Surg. 1963;86(1):43-50. doi:10.1001/archsurg.1963.01310070045006

A careful review of the English-language literature has disclosed 44 cases of aortoenteric fistula after aortic surgery, reported in 26 articles. We know of 26 additional instances of this condition. Twenty-two of these have occurred within our own experience, and in 11 repair was attempted.

A review of these 70 cases brings to light certain correlations from which tentative conclusions regarding etiology and prevention may be drawn.

Incidence  We have seen 20 cases of aortoenteric fistula in which we had done the original operation. We have also seen 24 instances of hemorrhage from an arterioplasty into the retroperitoneal space without involvement of the intestine. These 44 ruptures have occurred in a total of 850 abdominal aortic operations—an incidence of 5%. Of these 44, ten aortoenteric fistulae and 16 retroperitoneal hemorrhages were reoperated on in our hospital. Information concerning the remaining 18 cases was derived from a vigorous followup program. There

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