HemoChat is an evidence-based AI medical search tool covering all major clinical domains, powered by 46,298 SNOMED-CT concepts, clinical guidelines, and live PubMed literature.

What medical domains does HemoChat cover?

HemoChat covers all major medical domains including cardiology, oncology, neurology, hematology, pulmonology, endocrinology, gastroenterology, psychiatry, nephrology, rheumatology, musculoskeletal, and more — with 46,298 SNOMED-CT concepts.

Is HemoChat a replacement for clinical judgment?

No. HemoChat is for clinical reference only and is not a substitute for professional medical judgment. Always consult qualified healthcare professionals for medical decisions.

What AI technology does HemoChat use?

HemoChat uses a hybrid GraphRAG + VectorRAG pipeline combining Neo4j knowledge graphs with FAISS vector search and an LLM for answer generation.

Traumatic aorto-enteric fistula — Clinical Guidelines

Overview

Traumatic aorto-enteric fistulas are abnormal connections between the aorta, often involving a prosthetic graft, and the gastrointestinal tract, typically presenting as gastrointestinal bleeding or abdominal pain 1 3 5.

Diagnosis

Clinical Presentation: Gastrointestinal bleeding, abdominal or back pain, and presence of an abdominal mass 3.

Diagnostic Imaging:

- CT Scan: Key signs include perigraft soft tissue, fluid, ectopic air, bowel wall thickening, and contrast extravasation indicating active bleeding 2. - 18-FDG PET: Useful in diagnosing prosthetic graft infections or fistulas when conventional imaging is inconclusive 1. - Endoscopy: Often non-diagnostic but may help rule out other causes 3 5. - Barium Studies: Can be diagnostic, especially in post-aortic surgery patients 6.

Management

Surgical Intervention:

- Primary Treatment: Removal of the prosthetic graft and extra-anatomic bypass grafting 5. - Complex Cases: Additional procedures like renal autotransplantation may be necessary 7.

Emergency Exploratory Laparotomy: Indicated when fistula is suspected, especially post-aortic surgery 5.

Special Populations

Post-Aortic Surgery Patients: Higher suspicion for aorto-enteric fistulas in cases of gastrointestinal bleeding 5 6.

Key Recommendations

Suspect aorto-enteric fistula in patients with gastrointestinal bleeding post-aortic surgery (Evidence: Moderate 5 6).

Utilize CT scan with biphasic contrast for detailed imaging, focusing on signs of contrast extravasation and perigraft abnormalities (Evidence: Moderate 2).

Consider emergency exploratory laparotomy when fistula is suspected, as it is a safe diagnostic and potentially lifesaving approach (Evidence: Weak 5).

Remove the involved prosthetic graft and perform extra-anatomic bypass grafting for definitive treatment (Evidence: Expert opinion 5).

References

1 Tsunekawa T, Ogino H, Minatoya K, Matsuda H, Sasaki H, Fukuchi K. Masked prosthetic graft to sigmoid colon fistula diagnosed by 18-fluorodeoxyglucose positron emission tomography. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery 2007. link 2 Tacchini S, Nicoletti R, Ghio D, Martinenghi CM, Chiesa R, Del Maschio A. CT findings of secondary aorto-enteric fistulae. La Radiologia medica 2005. link 3 Nohr M, Juul-Jensen KE, Balslev IB, Jelnes R. Primary aorto-enteric fistula: a practicable curable condition? Pathogenetic and clinical aspects. International angiology : a journal of the International Union of Angiology 1990. link 4 Gutman H, Russo I, Neuman-Levin M, Haddad M, Zelikovski A. Computed tomography diagnosis of primary aorto-enteric fistula. Clinical imaging 1989. link90149-6) 5 Gozzetti G, Poggioli G, Spolaore R, Faenza A, Cunsolo A, Selleri S. Aorto-enteric fistulae: spontaneous and after aorto-iliac operations. The Journal of cardiovascular surgery 1984. link 6 Gregson R, Craig O. Aorto-enteric fistulae: the role of radiology. Clinical radiology 1983. link80385-7) 7 Mohr E, Sødal G. Aorto-enteric fistula. A case treated with insertion of a new dacron prosthesis and bilateral autotransplantation of the kidneys. Scandinavian journal of thoracic and cardiovascular surgery 1980. link

Traumatic aorto-enteric fistula