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Case Reports
. 2013 Jan 21;19(3):415-7.
doi: 10.3748/wjg.v19.i3.415.

Primary aortoduodenal fistula: a case report

Abdu Hassan Alzobydi  1 , Shaista Salman Guraya
Affiliations
Case Reports

Primary aortoduodenal fistula: a case report

Abdu Hassan Alzobydi et al. World J Gastroenterol. .

Abstract

Primary abdominoaortic fistula is an extremely rare cause of upper gastrointestinal (GI) bleeding. The diagnosis is frequently delayed due to the rarity of the disease and low index of suspicion by physicians. A range of invasive and non-invasive diagnostic tools are available, but helical computer tomography (CT) remains the mainstay. Surgery offers the only hope for survival. This case report presents a 47-year-old male with massive upper GI bleeding. Various diagnostic tests and an exploratory laparotomy failed to identify the diagnosis. Later, a primary aortoduodenal fistula was confirmed by CT scan which necessitated surgical repair of the fistula and a Goretex graft for the abdominal aortic aneurysm. The patient made an uneventful recovery and remained well to the first postoperative visit in the clinic 2 wk after surgery.

Keywords: Abdominal aortic aneurysm; Aortoduodenal fistula; Computer tomography; Mycotic aneurysm.

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Figures

Figure 1
Figure 1
Endoscopic views of the stomach (A) and duodenum (B) showing a huge amount of fresh blood emerging from a concealed source.
Figure 2
Figure 2
Computer tomography scan showing a primary aortoduodenal fistula between the infrarenal aorta and 4th part of the duodenum. A: Computer tomography (CT) scan without contrast showing a ruptured aortic aneurysm; B: Arterial phase of the CT scan showing the partially thrombosed abdominal aortic aneurysm.
See this image and copyright information in PMC

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