TY - JOUR
T1 - The red connection
T2 - a review of aortic and arterial fistulae with an emphasis on CT findings
AU - Sipe, Adam
AU - McWilliams, Sebastian R.
AU - Saling, Lauren
AU - Raptis, Constantine
AU - Mellnick, Vincent
AU - Bhalla, Sanjeev
N1 - Publisher Copyright:
© 2016, American Society of Emergency Radiology.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Fistulae between the aorta and adjacent structures are a rare, emergent, and potentially life-threatening process. Most commonly, aortic fistulae arise secondarily as a complication of prior aortic surgery with fistulization to adjacent structures. Rarely, a primary fistula may arise from the aorta in the setting of a pre-existing aneurysm or from a mass, inflammation, or infection. Although the incidence of aortic fistulae remains low, the frequency continues to increase as aortic surgical interventions and post-surgical follow-up with imaging become more common. Computed tomography (CT) is the modality of choice in evaluating the patient with suspected aortic fistula because of its accessibility and short scan time. In addition, CT allows for more clear depiction of para-aortic or intra-aortic gas than ultrasound or magnetic resonance (MR). This gas may be the first clue of a fistula. Given the high mortality associated with aortic fistulae, familiarity with the imaging findings of the spectrum of aortic fistulae is essential knowledge in the emergency setting. This review will discuss the imaging appearance of aortic and arterial fistulae to the bronchi, esophagus, gastrointestinal tract, ureters, and veins on CT.
AB - Fistulae between the aorta and adjacent structures are a rare, emergent, and potentially life-threatening process. Most commonly, aortic fistulae arise secondarily as a complication of prior aortic surgery with fistulization to adjacent structures. Rarely, a primary fistula may arise from the aorta in the setting of a pre-existing aneurysm or from a mass, inflammation, or infection. Although the incidence of aortic fistulae remains low, the frequency continues to increase as aortic surgical interventions and post-surgical follow-up with imaging become more common. Computed tomography (CT) is the modality of choice in evaluating the patient with suspected aortic fistula because of its accessibility and short scan time. In addition, CT allows for more clear depiction of para-aortic or intra-aortic gas than ultrasound or magnetic resonance (MR). This gas may be the first clue of a fistula. Given the high mortality associated with aortic fistulae, familiarity with the imaging findings of the spectrum of aortic fistulae is essential knowledge in the emergency setting. This review will discuss the imaging appearance of aortic and arterial fistulae to the bronchi, esophagus, gastrointestinal tract, ureters, and veins on CT.
KW - Aorta
KW - Aortic aneurysm
KW - Aortobronchial fistula
KW - Aortoenteric fistula
KW - Aortoesophageal fistula
KW - Arterioureteral fistula
KW - Fistula
UR - http://www.scopus.com/inward/record.url?scp=84983446149&partnerID=8YFLogxK
U2 - 10.1007/s10140-016-1433-y
DO - 10.1007/s10140-016-1433-y
M3 - Article
C2 - 27553778
AN - SCOPUS:84983446149
SN - 1070-3004
VL - 24
SP - 73
EP - 80
JO - Emergency Radiology
JF - Emergency Radiology
IS - 1
ER -