Diagnosis and therapy of secondary aortoenteric fistulas: results of 16 patients

From January 1977 to July 1997, 16 patients with aorto/iliac-enteric fistul as underwent repair. The fistula became apparent at a mean of 51 months. Ga strointestinal bleeding was the main symptom in 11 cases, 4 patients had a cutaneous fistula, and 1 developed retroperitoneal bleeding. The preoperati ve diagnosis was established in one-half of the cases. Three patients had t o be treated surgically on an emergency basis without a preoperative diagno sis because of bleeding, 7 patients were semi-urgent and 6 had elective sur gery. In 3 cases treatment consisted only of local repair. In 6 patients we performed extra-anatomic revascularization and in 7 patients we achieved r estoration by in situ replacement after removal of all infected prosthetic material. Eight of 16 patients survived the perioperative period. Local rep air alone cannot be recommended. All 3 patients died. The mortality rates b etween extraanatomic revascularization and in situ reconstruction are compa rable.