Lu Yuqin: Abdominal aortic aneurysm after the removal of the intestinal fistula to coincide with the treatment of large bleeding mouth

Clinically, when the diameter of the patient's abdominal aortic aneurysm is greater than or equal to 5.5 cm or if its diameter increases by 1 cm per year during follow-up, the physician recommends an abdominal aortic aneurysm excision.
abdominal aortic aneurysm may lead to intestinal fistula complications, the incidence of less than 2%, and in-cavity repair after intestinal fistula is rare, about 0.36%.
at a recent academic conference, Dr. Lu Yuqin, from Vascular Surgery at Zhejiang Provincial People's Hospital, explained in detail the treatment of intestinal fistula and mouth haemorrhage after abdominal aortic aneurysm removal with a specific case.
history of the hospital (male, 61 years old) main complaint: due to "lower abdominal pain for 6 hours" hospitalization.
: Patients 6 hours ago without obvious inducement to appear abdominal pain in the local hospital treatment.
CT: "The abdominal aortic intestinal membrane below the artery rupture", transferred to Zhejiang Provincial People's Hospital vascular surgery emergency.
physical examination: blood pressure: 80/45mm Hg, heart rate: 137bpm, unconscious, pale, wet and cold limbs.
emergency treatment (first) emergency treatment: emergency abdominal aorta partial removal, straight artificial blood vessels (6cm) end match.
1 week after surgery: intestinal fistula, 15 cm empty intestinal fistula below the ligament, two-sleeve flushing drainage, intestinal nutrition support.
january after the operation: "There was bleeding from the drainage mouth, hemorrhagic shock, considering a rupture of the matching mouth."
emergency treatment (second) emergency treatment: Emergency DSA down-line abdominal aortic rupture cladding stent cavity isolation, implanted in the abdominal aorta body 26 x 12 x 120 mm clad stent.
2 days after surgery: CTA prompts blood flow, broken mouth closed well, continuous double-sleeve flushing drainage after surgery, intestinal nutrition support.
is based on bacterial culture, anti-infection treatment.
the pathogenesis of intestinal fistula after open surgery to expand the reading pathogenesis abdominal aortic aneurysm is currently not a unified point of view.
some experts believe that the failure of artificial blood vessels in open surgery to properly envelist will cause patients to have intestinal fistula after open surgery, and some experts believe that artificial blood vessels over-distortion of the intestinal tract lasting compression and friction leading to postoperative intestinal fistula.
is also said to be that an inoperative injury or infectious aneurysm causes a patient to have a intestinal fistula.
Treatment method anti-inflammatory treatment: until the fever symptoms disappear for more than 1 week and three consecutive blood cultures are free of bacteria and fungal growth after a limited period of surgery treatment;
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