[Secondary aorto-enteral fistula--material of 22 years and literature review]. / Szekunder aorto-enteralis fisztulák--22 év anyaga és irodalmi áttekintés.

ABSTRACT

INTRODUCTION: Aorto-enteral fistula is a pathological communication between the aorta and the bowel lumen. In its secondary form is a dreaded, often fatal complication of the aorto-iliac operations. METHODS: We report 34 secondary fistulas, a great number of patients treated in the last 22 years. One can rarely find such a number in the literature. RESULTS: The incidence of secondary fistulas is 0.42% following aorto-iliac operations. We give a detailed description of diagnostics. We prefer in situ solutions (graft change, aorto-aortic interposition, iliac desobliteration, homograft or deep venous bypass, aorto-bifemoral bypass) to extra-anatomical bypasses. We emphasize the importance of the postoperative care, and the necessity of adequate antibiotic therapy. CONCLUSION: Despite improved operations and intensive care mortality is still high (55.88%). We find that prevention is of great importance.