Mehmet Akif TÜRKOĞLU, Mete AKIN, Veli VURAL, Halil ERBİS, Yasar TUNA, Mehmet İlker TURAN

Vena Kava İnferior Greft Penetrasyonuna Sekonder Duodenokaval Fistullerde Cerrahi Yaklasım

Duodenum ve inferior vena kava (İVK) arasında fistül olusumu nadir bir durumdur. Üst gastrointestinal kanamalardan sonra tanı konulabilir. Burada, hematemez ve melena ile belirti gösteren, üst gastrointestinal (Gİ) endoskopi ile tanı konulan İVK greft - duodenal fistül vakasını sunmaktayız. Abdominal bilgisayarlı tomografisi normal olarak rapor edildi. Laparotomide, İVK Dakron greft ile bitisiğindeki duodenumun erozyonu gözlenhukukdi. Greft çıkarıldı ve duodenum iki kat kontinü sütürle omental yama uygulanarak onarıldı. Cerrahi, duodenokaval fistülde en iyi tedavi yaklasımıdır. Duodenumun iki kat kontinü sütür ile omental yama desteği cerrahi yaklasımda bir seçenek olabilir.

Surgical Approach for Duodenocaval Fistula Secondary to Inferior Vena Caval Graft Penetration

Fistula formation between the duodenum and inferior vena cava (IVC) is a rare entity. It may be diagnosed after upper gastrointestinal bleeding. Here in, we present a case of IVC graft- duodenal fistula manifesting with hematemesis and melena which was diagnosed by upper gastrointestinal (GI)endoscopy. Abdominal computed tomography (CT) was reported as normal. At laparotomy, an IVC dacron graf with erosion into the adherent duodenum was explored. The graft was removed and the duodenum was repaired by double- layer continuous suture with omental patchapplication. Surgery is the best therapeutic approach for treatment of dudodenocaval fistula. Double-layer continuous suture of duodenum supported by the application of an omental patch can be an option for surgical approach.

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