Paediatric Interventional Management of Primary Aorto-Enteric Fistula (PAEF)
To the editor,
An aorto-enteric fistula (AEF) is an abnormal communication between the aorta and the gastrointestinal (GI) tract. It can be classified into primary AEF (PAEF) and secondary AEF (SAEF). PAEFs commonly arise from an abdominal aortic aneurysm or inflammatory/infected aorta process (aortitis/sepsis) with an incidence of 0.04–0.07% .
SAEFs are an uncommon complication of aortic abdominal reconstruction with an incidence of 0.6–4%. SAEFs can be subcategorised into two types: Type 1, a ‘true’ AEF, which develops between the proximal aortic suture line and GI tract, and Type 2, a para-prosthetic enteric pseudo-fistula with no real communication (i.e. bleeding from an eroded bowel wall) . AEFs typically present with a primary trivial herald bleed that is sometimes followed by a life-threatening gastrointestinal haemorrhage . We present here a rare case of PAEF, diagnosed on CT angiography (CTA) and successfully treated with endovascular aortic repair. We review...
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Conflict of interest
The authors declare that they have no conflict of interest.
For publication purposes (prepared information and images are in an un-identifiable anonymised format), a written informed consent has been obtained from the patient and parent. Prior to that, a separate journalism consent was obtained by Nottingham Post from patient and parent .
All procedures performed in this report involving human participants were in accordance with the clinical ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
- 4.Blackburn P. Pioneering surgery—never before seen in Nottingham—saves life of teenage cancer patient. Nottingham Post. http://www.nottinghampost.com/news/health/pioneering-surgery-never-before-seen-1039124 (2017). Accessed 15 Jan 2018.
- 5.National Institute for Health and Clinical Excellence. Acute upper gastrointestinal bleeding in over 16s: management. NICE Guideline (CG141). https://www.nice.org.uk/corporate/ecd1/chapter/referencing-and-citations#reference-examples-journalsand-books (2012).
- 6.Wortman JR, Landman W, Fulwadhva UP, Viscomi SG, Sodickson AD. CT angiography for acute gastrointestinal bleeding: what the radiologist needs to know. Br J Radiol. 1075;2017(90):20170076.Google Scholar