[Aneurysms of the aorta and its visceral branches as a cause of gastrointestinal hemorrhage]. / Anevrizma aorty i ee vistseral'nykh vetvei kak prichina zheludochno-kishechnykh krovotechenii.

ABSTRACT

From 1993 till 1999 6 patients with aneurysmointestinal fistulas complicated by bleedings were operated. In 4 cases the aneurysmointestinal fistulas were primary, in 2 cases--secondary. Gastroduodenoscopy, ultrasonic examination of abdominal organs, retroperitoneal space and duplex scanning of main vessels were used. Correct diagnosis before operation was made in 5 patients. The following operations on the vessels were performed suturing of defect of central anastomosis (1), aortobifemoral grafting (1), abdominal aorta grafting (2), suturing of aortal defect (1), resection of peripheral aneurysm (1). Thrombosis of prosthesis branch (1) and suppuration of prosthesis bed with arrhosive bleeding (2) were early postoperative complications. Immediate postoperative lethality was 33.3%. Long-term results are followed in 3 patients. There were no repeated signs of graft infection in remote period. Basic methods of clinical and instrumental examination including ultrasound permit to make correct diagnosis before operation. Active surgical policy saves the life in the majority of patients, but it is necessary to use carefully the synthetic grafts for arterial vessels repair.