Secondary aortoenteric fistula. A 20 year experience

Charles S. O'Mara, G. Melville Williams, Calvin B. Ernst

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


During a 20 year period at the Johns Hopkins Medical Institutions, 17 patients were operated on for secondary aortoenteric fistula. The interval from initial operation to the onset of symptoms varied greatly and averaged 2.8 years. Symptoms included not only gastrointestinal bleeding but also sepsis and abdominal or back pain. Associated advanced cardiovascular disease was common. Helpful preoperative diagnostic studies included esophagogastroduodenoscopy, aortography, barium contrast gastrointestinal series and groin sinography. However, a high index of suspicion was the most important element of diagnosis. Overall operative mortality was high (47 percent). All six patients with a graft left in the retroperitoneum had an unsatisfactory result (four instances of recurrent aortoenteric fistula). Successful repair was accomplished only in those patients undergoing graft excision and axillofemoral bypass.

Original languageEnglish (US)
Pages (from-to)203-209
Number of pages7
JournalThe American Journal of Surgery
Issue number2
StatePublished - Aug 1981

ASJC Scopus subject areas

  • Surgery


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