[Primary aortoduodenal fistula: risk of fatal bleeding]

Abstract

A primary aortoduodenal fistula is a life-threatening cause of haematemesis. Early recognition is essential for the prevention of complications and death. We describe the case of an 82-year-old man with acute haematemesis and melaena resulting from this condition. The diagnostic procedures included a gastroduodenoscopy and computed tomography angiography (CTA). The fistula was surgically removed, with neighbouring parts of the duodenum and aorta. The duodenum was closed by a simple anastomosis; the aorta by the introduction of a Dacron graft. The postoperative course was uneventful. Surgical intervention is the treatment of choice in patients with an aortoduodenal fistula.