Abstract
A 53-year-old man operated for a retroperitoneal tumor suffered from massive melena of sudden onset and developed hemorrhagic shock on the 12th day after the operation. No improvement of the hemodynamic status was obtained with rapid infusion of fluids and a vasoconstrictor agent. We started cardiopulmonary resuscitation because the patient showed agonal breathing and attenuation of the pupillary light reflex. A large amount of blood was transfused which provided some hemodynamic stability. An emergency digital subtraction angiography of the left external iliac artery demonstrated extravasation of the intra-arterial contrast medium into the bowel lumen. We made a diagnosis of arterioenteric fistula and performed a stent-graft transplantation covering the fistula entry. Although the hemodynamics improved with this procedure, the patient’s general status worsened and he died of multiple organ failure 29 hours later. We report a case of arterioenteric fistula that followed a rapidly fatal course. We have discussed what might be needed for life-saving potential life-saving measures?.
