Method of endoscopic stopping of gastroduodenal bleeding due to aortoduodenal fistula

BACKGROUND: Aortoduodenal fistula (ADF) is an extremely rare pathology encountered in 0.04–0.07% of cases, according to published data. This pathological communication between the aorta and duodenum results from topographic and anatomic peculiarities of the mutual arrangement of the abdominal aorta and duodenum. The most common complication of ADF is massive gastrointestinal bleeding with extremely high mortality rate (up to 100% without treatment and 30–40% with surgical treatment). This article describes a case of treatment of ADF complicated with bleeding using a developed method of endoscopic hemostasis, which consists in a combined use of two powdered hemostatic agents and a granulated cytoprotective sorbent. CONCLUSION: The proposed method of endoscopic stopping of gastroduodenal bleeding provided reliable hemostasis, prevented recurrent hemorrhage, gained time for diagnostic search and successful performance of radical surgery at a specialized vascular center.