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A case of aortocolonic fistula caused by sigmoid diverticulitis

Published byあけなお けいれい Modified over 5 years ago

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Presentation on theme: "A case of aortocolonic fistula caused by sigmoid diverticulitis"— Presentation transcript:

1 A case of aortocolonic fistula caused by sigmoid diverticulitis
Ryosuke Kowatari, MD, Hanae Sasaki, MD, Shintaro Goto, MD, Yuki Imamura, MD, Chikashi Aoki, MD, PhD, Ikuo Fukuda, MD, PhD  Journal of Vascular Surgery Cases and Innovative Techniques  Volume 5, Issue 2, Pages (June 2019) DOI: /j.jvscit Copyright © 2019 The Author(s) Terms and Conditions

2 Fig 1 Preoperative computed tomography showing (a) an enlarged sac around the occluded right leg of the prosthetic graft with gas bubbles surrounding the graft; (b) three high-density spots between the enlarged sac and sigmoid colon. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 78-81DOI: ( /j.jvscit ) Copyright © 2019 The Author(s) Terms and Conditions

3 Fig 2 Schema of the presented aortocolonic fistula (ACF) showing the resection line of the aorta, prosthetic graft, and sigmoid colon (dotted line). Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 78-81DOI: ( /j.jvscit ) Copyright © 2019 The Author(s) Terms and Conditions

4 Fig 3 The resected specimen confirms the presence of three aortocolonic fistulas (ACFs) and pseudoaneurysm surrounding the site of the ruptured distal anastomosis. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 78-81DOI: ( /j.jvscit ) Copyright © 2019 The Author(s) Terms and Conditions

5 Fig 4 Microscopic pathology. a, Low-power field showing that the demarcation line between the pseudoaneurysm and sigmoid colon was unclear because of advanced fibrosis (arrowheads). In addition, loss of intestinal smooth muscle continuity was observed near the fistulas (dotted line). b, High-power field on the intestinal side of the fistula showing granulation with marked neutrophilic infiltration. c, High-power field on the aortic side of the fistula showing the presence of substantial intestinal tract content in the aorta (arrowheads). Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 78-81DOI: ( /j.jvscit ) Copyright © 2019 The Author(s) Terms and Conditions

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