Журнал сосудистой медицины и хирургии

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Fatal Gastrointestinal Bleeding Probably Caused by an Aortoduodenal Fistula Following Surgical Repair of an Inflammatory Abdominal Aortic Aneurysm during Postoperative Steroid Therapy

Akihiko Ikeda, Toru Tsukada, Taisuke Konishi, Kanji Matsuzaki and Tomoaki Jikuya

We describe a case of fatal gastrointestinal bleeding probably caused by an aortoduodenal fistula following open surgical repair of an inflammatory abdominal aortic aneurysm (AAA) during postoperative steroid therapy. A 71-year old man underwent a graft replacement for an inflammatory AAA. Prolonged elevated C-reactive protein and newly emerged ascites after surgery were improved by oral administration of predonine. The steroid therapy had been continued until 5 months after surgery, when he suffered from fatal gastrointestinal bleeding. We speculated that the gastrointestinal bleeding was caused by an aortoduodenal fistula and discuss the etiology of this condition.