Aortic enteric fistula

Aortic enteric fistula

This diagnosis should be considered in any patient with haematemesis and melaena that cannot be otherwise explained. Contrary to expectation, the bleeding from such patients is not always massive. V ery often there is nothing much to distinguish between the bleeding from the aortic enteric fistula and any other recurrent upper gastrointestinal bleeding. The vast Robert William Sengstaken Sr , 1923–1978, surgeon, Garden City , New Y ork, NY , USA. Arthur Blakemore , 1897–1970, surgeon, The Columbia College of Physicians and Surgeons, New Y ork, NY , USA. - majority of patients will have had an aortic graft; however, it is occasionally seen in patients with an untreated aortic aneurysm. A CT scan with intravenous contrast will confirm the diagnosis. Treatment requires aortic aneurysm or aortic graft excision/replacement and carries a high mortality (see Chapter 61 ).

Oesophageal aspiration channel Oesophageal balloon: 40 mmHg Gastric balloon: at least 300 mL of air Gastric aspiration channel Figure 67.24 Balloon tamponade of gastric and oesophageal varices with a Sengstaken–Blakemore tube. The balloons should be de /f_l ated every 12 hours to prevent pressure necrosis.