Imaging Pearls ❯ Vascular ❯ Aortoenteric fistulae
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- “Prompt diagnosis of aortoenteric fistulas is imperative for patient survival. The clinical signs of aortoenteric fistula include hematemesis, melena, sepsis, and abdominal pain, but the condition also may be clinically occult. Because clinical signs may not be present or may not be sufficiently specific, imaging is most often necessary to achieve an accurate diagnosis.”
Aortoenteric Fistulas: CT Features and Potential Mimics
Vu QDM et al.
RadioGraphics Jan 2009;29:197-2009 - “CT has widely variable sensitivity (40%–90%) and specificity (33%–100%) for the diagnosis of aortoenteric fistulas. To use this modality effectively for the initial diagnostic examination, radiologists must be familiar with the spectrum of CT appearances. Mimics of aortoenteric fistulas include retroperitoneal fibrosis, infected aortic aneurysm, infectious aortitis, and perigraft infection without fistulization..”
Aortoenteric Fistulas: CT Features and Potential Mimics
Vu QDM et al.
RadioGraphics Jan 2009;29:197-2009 - “Mimics of aortoenteric fistulas include retroperitoneal fibrosis, infected aortic aneurysm, infectious aortitis, and perigraft infection without fistulization. Differentiation is aided by the observation of ectopic gas, loss of the normal fat plane, extravasation of aortic contrast material into the enteric lumen, or leakage of enteric contrast material into the paraprosthetic space; these features are highly suggestive of aortoenteric fistula in a patient with bleeding in the gastrointestinal tract.”
Aortoenteric Fistulas: CT Features and Potential Mimics
Vu QDM et al.
RadioGraphics Jan 2009;29:197-2009 - “Aortoenteric fistula, a rare but potentially fatal entity, presents a significant challenge to radiologists in diagnosis, largely because of its subtle and nonspecific imaging findings. These fistulas can be divided into primary and secondary forms, depending on the presence or absence of prior aortic reconstructive surgery, but the secondary form is more common.”
Aortoenteric Fistulas: Spectrum of CT Findings
Raman SP, Kamaya A, Federle MP, Fishman EK
Abdom Inaging 2012 Feb 25 (Epub ahead of print) - “Typical CT findings, which can overlap with those seen in perigraft infection, aortitis, infected/mycotic aneurysms, perianeurysmal fibrosis, and the immediate post-operative period after placement of a graft, include: Effacement of the fat planes around the aorta, perigraft fluid/soft tissue thickening, ectopic gas, tethering of adjacent thickened bowel loops towards the aortic graft, and in rare cases, extravasation of contrast from the aorta into the involved segment of bowel.”
Aortoenteric Fistulas: Spectrum of CT Findings
Raman SP, Kamaya A, Federle MP, Fishman EK
Abdom Inaging 2012 Feb 25 (Epub ahead of print) - “ Aortoenteric fistula, a rare but potentially fatal entity, presents a significant challenge to radiologists in diagnosis, largely because of its subtle and nonspecific imaging findings. These fistulas can be divided into primary and secondary forms, depending on the presence or absence of prior aortic reconstructive surgery, but the secondary form is more common.”
Aortoenteric fistulas: Spectrum of CT findings
Raman SP, Kamaya A, Federle MP, Fishman EK
Abdom Imaging 2012 Feb 25 (epub ahead of print) - “Typical CT findings, which can overlap with those seen in perigraft infection, aortitis, infected/mycotic aneurysms, perianeurysmal fibrosis, and the immediate post-operative period after placement of a graft, include: Effacement of the fat planes around the aorta, perigraft fluid/soft tissue thickening, ectopic gas, tethering of adjacent thickened bowel loops towards the aortic graft, and in rare cases, extravasation of contrast from the aorta into the involved segment of bowel.”
Aortoenteric fistulas: Spectrum of CT findings
Raman SP, Kamaya A, Federle MP, Fishman EK
Abdom Imaging 2012 Feb 25 (epub ahead of print)