title: An autopsy case of a primary aortoenteric fistula: a pitfall of the endoscopic diagnosis.
abstract: A primary aortoenteric fistula (PAEF), defined as a communication between the native aorta and the gastrointestinal tract, is a rare cause of gastrointestinal bleeding. The preoperative diagnosis of PAEF is extremely difficult. Consequently, PAEF may cause sudden and unexpected death. We present an autopsy case of a 68-year-old man who died of massive gastrointestinal bleeding due to a PAEF. Autopsy revealed a pinhole rupture located on the third part of the duodenal mucosa and fistulized into the adjacent abdominal aortic aneurysm (AAA). Our case indicates that the aortoenteric fistula can result in fatal gastrointestinal bleeding. Consequently, a PAEF should be included in the differential diagnosis of gastrointestinal bleeding.
authors.affiliation: Department of Legal Medicine, School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, Japan. makino@med.u-ryukyu.ac.jp
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ihama
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Chiaki
authors.initials: C
authors.lastname: Fuke
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ihama
authors.forename: Ryoji
authors.initials: R
authors.lastname: Matayoshi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kohatsu
authors.forename: Fukunori
authors.initials: F
authors.lastname: Kinjo
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000473:pathology; D001018:Aortic Diseases / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004378:Duodenal Diseases / Q000150:complications / Q000175:diagnosis*; D004386:Duodenum / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000175:diagnosis*; D008297:Male