title: Clinical presentation of a missed primary aorto-enteric fistula.
abstract: Primary aortoenteric fistula is a rare but potentially fatal cause of gastrointestinal bleeding. The diagnosis of primary aortoeteric fistula is difficult to make and is usually accompanied by a very high level of clinical suspicion. In the context of a known abdominal aortic aneurysm it is reasonable to have a high index of clinical suspicion ofaortoenteric fistula. It should be included in the differential diagnosis with low back pain and a palpable midline abdominal mass in a haemodynamically stable patient. We present a case of a 59 year old man with no past history of abdominal aortic aneurysm presented with lower back and periumblical pain. Initial misdiagnosis led to a delay in treatment and the patient succumbed to the illness.
authors.affiliation: Lincoln County Hospital, 1/2 Rowan House, St. Anne's Close, Lincoln, Ireland.
authors.forename: Rao Khalid
authors.initials: RK
authors.lastname: Mehmood
authors.forename: Abid
authors.initials: A
authors.lastname: Mushtaq
authors.forename: David R
authors.initials: DR
authors.lastname: Andrew
authors.forename: George Allan
authors.initials: GA
authors.lastname: Miller
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis; D001018:Aortic Diseases / Q000175:diagnosis* / Q000503:physiopathology; D003951:Diagnostic Errors; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis* / Q000503:physiopathology; D017116:Low Back Pain / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016157:Vascular Fistula / Q000175:diagnosis* / Q000503:physiopathology