0
ARTICLE |

Protection of the Abdominal Aortic Anastomosis

HENRY R. MADOFF, MD
Arch Surg. 1983;118(6):774. doi:10.1001/archsurg.1983.01390060090022.
Text Size: A A A
Published online

To the Editor.—The protection of the duodenum from the development of an aortoenteric fistula following aneurysm resection and graft replacement has been a concern of surgeons since the initiation of the procedure. NumerCreation of barrier against fistula using remaining aneurysm wall. ous techniques1-5 have been proposed to prevent this complication. With the development of the inclusion technique,6 a large amount of aneurysm wall remains, permitting construction of a barrier of thickened aneurysmal wall between the proximal anastomotic line and the overlying duodenum.

Following the insertion of the graft to replace the aneurysm, a flap of aneurysm wall is fashioned from either side of the remaining aortic wall (Figure). This is swung anteriorly over the proximal anastomotic line and sutured to tissue overlying the proximal portion of the aorta with interrupted 3-0 polyglycolic acid sutures, with care being taken to avoid entering the vessel. The remainder of the

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();