Secondary aortoenteric fistula: active bleeding detected with multi-detector-row CT.
We report a case of active bleeding of a secondary aortoenteric fistula (SAEF), in which CT angiography with multi-detector-row CT (MDCT) was finally diagnostic after negative catheter angiography and unsatisfactory endoscopy. The MDCT angiography clearly demonstrated the fistulous tract between the abdominal aortic graft and the duodenum. The dynamic process of bleeding was confirmed as a net increase of contrast agent accumulation in the duodenum through different phases. The MDCT angiography with its excellent 3D image quality is therefore a valuable method in the assessment of active SAEF bleeding.
Roos
Justus E
JE
Institute of Diagnostic Radiology, University Hospital Zürich, Rämistrasse 100, 8091 Zurich, Switzerland.
Willmann
Jürgen K
JK
Hilfiker
Paul R
PR
D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery; D001018:Aortic Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004386:Duodenum / Q000000981:diagnostic imaging / Q000601:surgery; D016145:Endoscopy, Digestive System; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis*; D008297:Male; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016157:Vascular Fistula / Q000175:diagnosis*