Gianluca Massaini¹*, Nicola Troisi², Carlo Pratesi¹ and Stefano Michelagnoli³

¹Department of Vascular Surgery, University of Florence, Italy
²Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
³Department of Surgery, Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy

*Corresponding Author: Gianluca Massaini, Department of Surgery, Vascular and Endovascular Surgery Unit, Careggi Hospital, University Florence, Italy.

Received: October 24, 2021; Published: September 21, 2022

Abstract

Objectives: Aortoduodenal syndrome is a rare clinical condition with duodenal obstruction caused by an abdominal aortic aneurysm (AAA). We report the case of a 60-year-old patient with aortoduodenal syndrome successfully treated by means of open repair.

Methods: A 60-year-old man with history of smoking and hypertension came to Emergency Department after a prolonged emesis (about 7 days). Direct computed tomography (CT)-scan detected a 9.2-cm infrarenal AAA with compression of the third part of duodenum. Acute renal failure and bowel occlusion were diagnosed and managed.

Results: Patient underwent open surgery. Surgical team included a visceral surgeon. An aortic standard repair was performed with a 20-mm Dacron tube graft. No bowel surgery was needed. 6-month CT-scan revealed a successful repair with no sequelae.

Conclusions: Open repair seems to be a good option in aortoduodenal syndrome management. Prompt management of clinical signs and symptoms is crucial to obtain successful outcomes.

Keywords: Abdominal Aortic Aneurysm; Aortoduodenal Syndrome; Duodenal Obstruction

Bibliography

1. Takagi H., et al. “ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. Aortoduodenal syndrome”. Journal of the International Union of Angiology 34 (2015): 454-458.
2. Takagi H., et al. “Aortoduodenal syndrome”. Journal of Vascular Surgery 43 (2006): 851.
3. Deitch JS., et al. “Abdominal aortic aneurysm causing duodenal obstruction: two case reports and review of the literature”. Journal of Vascular Surgery 40 (2004): 543-547.
4. Bozkurt H., et al. “Duodenal obstruction due to aortoduodenal syndrome”. Annali Italiani di Chirurgia (2019) 8.
5. Pachuau EL and Lallawmkima I. “Rare case of duodenal obstruction due to abdominal aortic aneurysm, "aortoduodenal syndrome": An Indian case report”. Indian Journal of Radiology and Imaging 30 (2020): 247-248.
6. Parashar K., et al. “Abdominal aortic aneurysm and its association with duodenal obstruction: aortoduodenal syndrome”. BJR Case Reports 6 (2020): 20200040.
7. Pham KD and Havre RF. “Treatment of aortoduodenal syndrome with endoscopic ultrasound-guided gastroenterostomy”. Endoscopy 52 (2020): E227-E228.
8. Esposito A., et al. “Endovascular treatment of a small infrarenal abdominal aortic aneurysm causing duodenal obstruction: Case report and literature review”. Vascular 23 (2015): 281-284.
9. Ahn KT., et al. “Endovascular treatment of aortoduodenal syndrome”. Annals of Vascular Surgery 31 (2016): 206.
10. Green B., et al. “Endovascular management of aortoduodenal syndrome: a novel treatment for a rare condition”. EJVES Extra 27 (2014): e13-e14.
11. Kawaguchi Y., et al. “Successful endovascular repair for abdominal aortic aneurysm presenting as aortoduodenal syndrome”. Annals of Vascular Diseases 13 (2020): 81-85.
12. Clarke RW., et al. “Aortoduodenal syndrome: a rare cause of duodenal obstruction in a patient with previous aortic aneurysm repair”. ANZ Journal of Surgery 89 (2019): e476-e477.
13. Sonesson B., et al. “Intra-aneurysm pressure measurements in successfully excluded abdominal aortic aneurysm after endovascular repair”. Journal of Vascular Surgery 37 (2003): 733-738.
14. Franga DL and Wiginton JG. “A rare presentation of ruptured abdominal aortic aneurysm leading to aortoduodenal syndrome”. Journal of Vascular Surgery Cases 2 (2016): 18-20.

Citation: Gianluca Massaini., et al. “Aortoduodenal Syndrome: Case Report and Review of the Literature". Acta Scientific Clinical Case Reports 3.10 (2022): 12-15.

Copyright: © 2022 Gianluca Massaini., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.