1. [Duodeno-caval fistula: a rare cause of upper gastrointestinal hemorrhage].
- Author
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Runkel N, Riede E, Kroesen AJ, Wiegel T, and Buhr HJ
- Subjects
- Adult, Carcinoma, Renal Cell radiotherapy, Carcinoma, Renal Cell surgery, Combined Modality Therapy, Duodenal Diseases etiology, Duodenum radiation effects, Duodenum surgery, Gastrointestinal Hemorrhage etiology, Humans, Intestinal Fistula etiology, Kidney Neoplasms radiotherapy, Kidney Neoplasms surgery, Lymphatic Irradiation, Male, Nephrectomy, Postoperative Complications etiology, Postoperative Complications surgery, Radiation Injuries etiology, Radiotherapy, Adjuvant, Reoperation, Duodenal Diseases surgery, Gastrointestinal Hemorrhage surgery, Intestinal Fistula surgery, Radiation Injuries surgery, Vena Cava, Inferior radiation effects, Vena Cava, Inferior surgery
- Abstract
Non-traumatic duodenocaval fistulae are rare, but may be the source of massive gastrointestional bleeding with associated fever and sepsis. These fistulae result from penetrating duodenal peptic ulcers or right nephrectomy and subsequent radiation to the upper abdomen. The outcome depends on early diagnosis and surgery before a potentially fatal hemorrhage occurs. The therapy of choice includes closure of the fistula and repair of the duodenum and inferior vena cava. We describe the seventh case with radiogenic duodenal ulcer. Gastrointestinal bleeding occurred 10 years after radical nephrectomy and radiation (60 Gy). The patient survived following partial pancreatoduodenectomy (Whipple).
- Published
- 1998
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