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Journal of Negative and No Positive Results
versão On-line ISSN 2529-850X
Resumo
LOZANO, Francisco S et al. Aorto-enteric fistula and Murphy's law. JONNPR [online]. 2020, vol.5, n.7, pp.702-720. Epub 05-Jul-2021. ISSN 2529-850X. https://dx.doi.org/10.19230/jonnpr.3727.
Objective.
To reflect our frustration when losing a patient, not because their infrequent pathology is in itself very serious, but because of the accumulation of other diagnostic and therapeutic reasons in a hospital environment of the Covid-19 epidemic.
Method.
First we describe the diagnostic, therapeutic and evolutionary process (February 27 to March 25, 2020) of a 73-year-old male with an aorto-enteric fistula secondary to an aorto-bifemoral bypass, implanted twelve years earlier in another hospital. Then we present our experience (1978-2020) in this type of situation, and finally we carried out a review of the literature (1953-2020) in this regard.
Results.
A) Clinical case: absence of early diagnosis, failure of the chosen operative technique, significant postoperative complications (hemorrhage, cerebral infarction and bilateral coronavirus pneumonia) that ended in death. B) Personal experience: four cases (including the referred one). C) Literature review: three systematic reviews: 564 cases (1953-1993); 386 cases in 58 publications (1991-2006), 823 patients in 216 publications (1995-2015) and 20 cases in 14 publications (2016-2020).
Conclusion.
If in normal situations an aorto-enteric fistula is a condition that seriously threatens the patient's life (hemorrhage and / or infection), it should not be surprising that in exceptional situations this serious situation increases. However, from these bad experiences we are obliged to draw lessons that will benefit others in the future.
Palavras-chave : Aortoenteric fistula; aortoduodenal fistula; secondary aortoenteric fistula; secondary aortoduodenal fistula; graft-enteric fistulas; paraprosthetic fistula; graft-enteric erosions.