Management of Aorto-Duodenal Fistula: Case Series and Technical Notes

Roberto Santoro; Laura Antolino; Debora Maruca; Vittorio Brizi; Manuela Brighi; Antonio Bovino; Armando Raso; Fabrizio Chegai; Emanuele Santoro; Antonio Lorido

doi:10.62713/aic.3920

journal article Open Access Jan 10, 2025

Management of Aorto-Duodenal Fistula: Case Series and Technical Notes

Roberto Santoro Laura Antolino Debora Maruca Vittorio Brizi Manuela Brighi Antonio Bovino Armando Raso Fabrizio Chegai Emanuele Santoro Antonio Lorido

Annali Italiani di Chirurgia Vol. 96 No. 1 · Annali Italiani di Chirurgia

View at Publisher Save 10.62713/aic.3920

Abstract

Aorto-duodenal fistula (ADF) is a rare clinical condition characterized by abnormal communication between the 3rd or 4th portion of the duodenum and the aorta, typically associated with aneurysmal disease. The incidence of ADF is expected to increase, however, there remains a lack of consensus on the optimal approach for intestinal restoration. In this study, we present three cases of ADF and their respective treatments using three distinct surgical techniques. Initially, endovascular aortic repair was employed as a life-saving procedure, followed by elective open repair. The choice of surgical technique was determined based on the patients' overall health conditions and the specific characteristics of the duodenal defect. In all cases, an omental patch was utilized to separate the aortic plane from the intestinal staple lines, providing additional protection for the sutures. The importance of a multimodal treatment strategy cannot be overstated, given the complex interplay of vascular, intestinal, and septic factors involved in the treatment of ADF.

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Published: Jan 10, 2025
Vol/Issue: 96(1)
License: View

Authors

R

Roberto Santoro

Chirurgia Generale Oncologica, PO Belcolle, ASL Viterbo, 01100 Viterbo, Italy

L

Laura Antolino

Chirurgia Generale Oncologica, PO Belcolle, ASL Viterbo, 01100 Viterbo, Italy; Fellowship of the Italian Society of Surgical Oncology SICO - ESSO Affiliated, 80100 Napoli, Italy

D

Debora Maruca

Chirurgia Vascolare, PO Belcolle, ASL Viterbo, 01100 Viterbo, Italy

V

Vittorio Brizi

Chirurgia Vascolare, PO Belcolle, ASL Viterbo, 01100 Viterbo, Italy

M

Manuela Brighi

Chirurgia Generale Oncologica, PO Belcolle, ASL Viterbo, 01100 Viterbo, Italy

A

Antonio Bovino

Chirurgia Generale Oncologica, PO Belcolle, ASL Viterbo, 01100 Viterbo, Italy

A

Armando Raso

Radiologia Interventistica, PO Belcolle, ASL Viterbo, 01100 Viterbo, Italy

F

Fabrizio Chegai

Radiologia Interventistica, PO Belcolle, ASL Viterbo, 01100 Viterbo, Italy

E

Emanuele Santoro

Chirurgia Generale ed Oncologica, AO San Giovanni Addolorata, 00184 Roma, Italy

A

Antonio Lorido

Chirurgia Vascolare, PO Belcolle, ASL Viterbo, 01100 Viterbo, Italy

Cite This Article

Roberto Santoro, Laura Antolino, Debora Maruca, et al. (2025). Management of Aorto-Duodenal Fistula: Case Series and Technical Notes. Annali Italiani di Chirurgia, 96(1). https://doi.org/10.62713/aic.3920

Management of Aorto-Duodenal Fistula: Case Series and Technical Notes

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