The life of a patient with a rare pathology was saved in the MC Erebоuni
A 69-year-old man was hospitalized in the MC Erebouni with a preliminary diagnosis of acute gastrointestinal bleeding and anemia. Recurrent bleeding began a year ago, which is why the patient was hospitalized several times in various medical institutions, but the cause of the bleeding has not been clarified. In MC Erebouni, all the necessary examinations were carried out, as a result of which it was possible to find out the problem. With the help of multi-organ CT angiography in the area of the infrarenal aorta, the left renal artery had an aneurysmal enlargement measuring 48x37mm, the height of the aneurysm was 3cm, the right anterior wall of the aneurysm bulged pear-shaped to the distal part of the duodenum, at the same level, the thin connection of the aneurysm lumen with the wall of the duodenum was weakly differentiated. A consultation of leading specialists was held. Analyzing the results of anamnestic, clinical laboratory and instrumental studies of the patient, an aorto-duodenal fistula was diagnosed. Taking into account the general condition of the patient and prolonged bleeding, it was decided to perform the surgery. It was carried out by Deputy General Director of MC Erebouni for Surgery Dr. Ara Vardanyan, Head of Vascular and Laser Surgery Department Dr. Aram Badalyan, (assistants Avetik Hovhannisyan, Hakob Sarkisyan, Evgine Kocharyan, Tigranuhi Hovsepyan, anesthesiologist Rimma Jagatspanyan): A unique surgery has been performed: separation of aorto-intestinal fistula, alloprosthetics of infrarenal abdominal aorta, resection of the duodenum, formation of duodenojejunal side-by-side anastamosis, sanitation and drainage of the abdominal cavity and retroperitoneal space. During the pathological examination an aortodoudenal fistula measuring 4 mm was found. The postoperative period passed without complications. The patient was discharged after 13 days with recovery.