title: Secondary aortoduodenal fistula with a fatal outcome: report of six cases.
abstract: Secondary aortoenteric fistulas (AEFs) are a well-known but uncommon cause of gastrointestinal hemorrhage. They usually occur secondary to reconstructive surgery of an abdominal aneurysm. We report six cases of secondary aortoduodenal fistulas, involving patients who, despite presenting with classic "herald bleeding," died as a result of delayed operative intervention. We also discuss the pathogenesis, clinical presentation, and diagnosis of AEFs, emphasizing the value of clinical suspicion and negative endoscopy in establishing the diagnosis and the need for early operative intervention.
authors: Department of Endoscopy and Motility Unit, Aristotle University, G.Gennimatas Hospital, Ethnikis Aminis 41, 546 35 Thessaloniki, Greece.
authors: Panagiotis
authors: P
authors: Katsinelos
authors: George
authors: G
authors: Paroutoglou
authors: Basilios
authors: B
authors: Papaziogas
authors: Athanasios
authors: A
authors: Beltsis
authors: Kostas
authors: K
authors: Mimidis
authors: Ioannis
authors: I
authors: Pilpilidis
authors: Panagiotis
authors: P
authors: Tsolkas
authors: Kostas
authors: K
authors: Soufleris
authors: Stergios
authors: S
authors: Vradelis
authors: Ioannis
authors: I
authors: Koutelidakis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000209:etiology* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D003951:Diagnostic Errors; D004378:Duodenal Diseases / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D008297:Male; D013997:Time Factors; D016157:Vascular Fistula / Q000209:etiology*