Fístula aorto-entérica y ley de Murphy

  1. Lozano, Francisco S. 1
  2. Parreño, Felipe 2
  3. Parra, María 3
  4. González, José I. 4
  5. Peña, Rubén 5
  6. Diego, Elisa 6
  7. Rubio, Carola 7
  1. 1 MD, PhD, FACS, FACA. Jefe servicio y catedrático de cirugía. Servicio de Angiología y Cirugía Vascular. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de Investigación Biomédica de Salamanca (IBSAL). Universidad de Salamanca (USAL). España
  2. 2 MD, PhD. Médico adjunto y profesor asociado de cirugía. Servicio de Cirugía General y del Aparato Digestivo. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de Investigación Biomédica de Salamanca (IBSAL). Universidad de Salamanca (USAL). España
  3. 3 MD. Médico adjunto. Servicio de Angiología y Cirugía Vascular. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de Investigación Biomédica de Salamanca (IBSAL). Universidad de Salamanca (USAL). España
  4. 4 MD. Médico adjunto y profesor asociado de cirugía. Servicio de Cirugía General y del Aparato Digestivo. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de Investigación Biomédica de Salamanca (IBSAL). Universidad de Salamanca (USAL). España
  5. 5 MD. Médico adjunto y profesor asociado de cirugía. Servicio de Angiología y Cirugía Vascular. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de Investigación Biomédica de Salamanca (IBSAL). Universidad de Salamanca (USAL). España
  6. 6 MD. Residente de cirugía. Servicio de Cirugía General y del Aparato Digestivo. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de Investigación Biomédica de Salamanca (IBSAL). Universidad de Salamanca (USAL). España
  7. 7 MD, PhD. Médico adjunto y profesor asociado de cirugía. Servicio de Angiología y Cirugía Vascular. Complejo Asistencial Universitario de Salamanca (CAUSA). Instituto de Investigación Biomédica de Salamanca (IBSAL). Universidad de Salamanca (USAL). España
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Journal:
Journal of Negative and No Positive Results: JONNPR

ISSN: 2529-850X

Year of publication: 2020

Volume: 5

Issue: 7

Pages: 702-720

Type: Article

DOI: 10.19230/JONNPR.3727 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: Journal of Negative and No Positive Results: JONNPR

Abstract

Objective. To reflect our frustration when losing a patient, not because their infrequent pathology is in itself  very serious, but because of the accumulation of other diagnostic and therapeutic reasons in a hospital  environment of the Covid-19 epidemic. Method. First we describe the diagnostic, therapeutic and evolutionary process (February 27 to March 25, 2020) of a 73-year-old male with an aorto-enteric fistula secondary to an aorto-bifemoral bypass, implanted  twelve years earlier in another hospital. Then we present our experience (1978-2020) in this type of situation,  and finally we carried out a review of the literature (1953-2020) in this regard. Results. A) Clinical case: absence of early diagnosis, failure of the chosen operative technique, significant postoperative complications (hemorrhage, cerebral infarction and bilateral coronavirus pneumonia) that ended in death. B) Personal experience: four cases (including the referred one). C) Literature review: three systematic reviews: 564 cases (1953-1993); 386 cases in 58 publications (1991-2006), 823 patients in 216 publications (1995-2015) and 20 cases in 14 publications (2016-2020).  Conclusion. If in normal situations an aorto-enteric fistula is a condition that seriously threatens the patient's life (hemorrhage and / or infection), it should not be surprising that in exceptional situations this serious situation increases. However, from these bad experiences we are obliged to draw lessons that will benefit others in the future.  

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