PARAPLEGIA AFTER SURGICAL-TREATMENT OF A PRIMARY AORTODUODENAL FISTULA

A 68-year-old patient with chronic cirrhosis underwent surgical repair of the subrenal abdominal aorta presenting an aorto-duodenal fistula, The fistula was considered to be a primary fistula because it occurre d without prior surgery and because the aorta had ruptured without for mation of an aneurysm, The postoperative period was complicated by par aplegia further compromising the outcome in this severe condition. In general, there are several problems involved in the management of aort o-duodenal fistulae, Neither computed tomography of the abdomen nor ga stroduodenal endoscopy are able to provide the diagnosis in all cases before surgery, Surgical treatment is most often Conducted in an emerg ency setting requiring repair of both the digestive tract and of the v ascular lesions, It is also important to recognize the risk of neurolo gical events occurring intra-operatively. Prognosis is usually poor.