[A case of aorto-enteric fistula after reconstruction of an abdominal aortic aneurysm associated with Behçet's disease and special reference to 95 reported cases in Japan].

Abstract

A 45-year-old male with incomplete type of Behçet's disease was operated on because of abdominal aortic aneurysm. The post-operative course was uneventful. On twenty-one months after discharge, the patient noticed left leg pain and tarry stool, and was referred to our hospital. Computed tomography and angiography showed aorto-enteric fistula at the proximal aortic anastomotic site. Aortic reconstruction was performed, but the patient died on 36th post-operative day. We analysed the reports of 95 cases of aneurysm associated with vasculo-Behçet's disease in Japan. This series comprised 82 men, 9 women and 4 unknowns. The cases were classified to four groups, which were incomplete type (48 cases), complete type (27 cases), suspected type (12 cases) and unknown (8 cases). They had 46 aortic aneurysms and 108 peripheral aneurysms. Operation was performed on 29 aortic aneurysms and 73 peripheral aneurysms. Eleven aortic aneurysms and twelve peripheral aneurysms had anastomotic complication post-operatively. Four cases after reconstruction of abdominal aortic aneurysm was complicated with aorto-enteric fistula. They were all dead post-operatively. Vasculo-Behçet's disease with aortic aneurysm is comparatively a rare entity and morbidity and mortality is high because of its etiological characteristics.