title: Primary aortoduodenal fistula: Pitfalls and success in the endoscopic diagnosis.
abstract: Primary aortoenteric fistula is a rare but catastrophic cause of gastrointestinal bleeding. The diagnosis of primary aortoenteric fistula is difficult to make and is usually accompanied by a very high level of clinical suspicion. It should be considered in any elderly patient presenting with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm. Prompt surgical intervention is necessary. We present the case of a 78-year-old man with a history of atherosclerotic abdominal aortic aneurysm which is presented with massive upper gastrointestinal bleeding due to a primary aortoduodenal fistula. Initial misdiagnosis led to a delay in treatment and the patient succumbed to the illness.
authors.affiliation: Department of Gastroenterology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 151, Beer-Sheva, 84101, Israel. delgado@bgumail.bgu.ac.il
authors.forename: Jorge
authors.initials: J
authors.lastname: Delgado
authors.forename: Alan B
authors.initials: AB
authors.lastname: Jotkowitz
authors.forename: Bertha
authors.initials: B
authors.lastname: Delgado
authors.forename: Victoria
authors.initials: V
authors.lastname: Makarov
authors.forename: Solly
authors.initials: S
authors.lastname: Mizrahi
authors.forename: Gabriel
authors.initials: G
authors.lastname: Szendro