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May 1966

Aorticosigmoid Fistulization Following Aortic Resection

Author Affiliations

From the departments of surgery, Peter Bent Brigham Hospital, Harvard Medical School, Boston, and the Beverly Hospital and Beverly Hospital Research Foundation, Beverly, Mass.

Arch Surg. 1966;92(5):805-807. doi:10.1001/archsurg.1966.01320230153028

AORTICOINTESTINAL fistula is now a well-recognized complication following abdominal aortic grafting. Sepsis is frequently an associated feature of this catastrophe, and successful management of the problem continues to challenge the ingenuity of the vascular surgeon.

The vast majority of these communications develop between the graft and the duodenum, the jejunum and ileum being less frequently involved.1 We were unable to discover any reported instances of graft rupture into the colon, although undoubtedly, there have been unreported cases. The following case is presented as an example of aorticosigmoid fistulization and sepsis following the insertion of a knitted Dacron bifurcation graft. Our attempt to manage this patient without restoring aortic continuity met with prompt and unqualified failure. We feel that the unique clinical features associated with rupture at this unusual site and our experiences in dealing with this patient are worthy of report.

Report of Case  A 69-year-old man was first

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