title: Acute gastrointestinal bleeding due to primary aortoduodenal fistula: report of two rare cases.
abstract: Primary aortoduodenal fistulas are among the rare causes of gastrointestinal hemorrhage and are defined as communications between the native abdominal aorta and the duodenum. The mortality rate is very high if undiagnosed and untreated. Two male patients, 61- and 76-years-old, were admitted to the emergency unit at different times with the chief complaints of abdominal pain, gastrointestinal hemorrhage and pulsatile mass in their abdomen. The first case experienced sudden massive upper gastrointestinal bleeding while being prepared for an emergency operation in the intensive care unit, and cardiac arrest developed within a few minutes. After resuscitation and successful surgical operation, the patient woke up without any neurological defect or sequelae and was extubated at the 9th postoperative hour. The second patient, who had been wounded by gun shot 30 years previously was admitted to the hospital because of simple gastrointestinal hemorrhage. A para-aortic pseudo-aneurysm connected with the duodenum was diagnosed by computed tomography. After successful surgical operation, the patient was discharged. In this report, a case of ruptured primary aortic aneurysm and another case of para-aortic pseudo-aneurysm connected with the duodenum, both of which were treated successfully by surgical operation, are presented.
authors.affiliation: Clinic of Cardiovascular Surgery, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. ufuktutun@hotmail.com
authors.forename: Ufuk
authors.initials: U
authors.lastname: Tütün
authors.forename: Ayşen
authors.initials: A
authors.lastname: Aksöyek
authors.forename: Ahmet Tulga
authors.initials: AT
authors.lastname: Ulus
authors.forename: Ali Ihsan
authors.initials: AI
authors.lastname: Parlar
authors.forename: M Kamil
authors.initials: MK
authors.lastname: Göl
authors.forename: Murat
authors.initials: M
authors.lastname: Bayazit
mesh_terms: D000208:Acute Disease; D000368:Aged; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D004378:Duodenal Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016157:Vascular Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery