title: Enigma of primary aortoduodenal fistula.
abstract: A diagnosis of primary aortoenteric fistula is difficult to make despite a high level of clinical suspicion. It should be considered in any elderly patient who presents with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm. We present the case of young man with no history of abdominal aortic aneurysm who presented with massive upper gastrointestinal bleeding. Initial misdiagnosis led to a delay in treatment and the patient succumbing to the illness. This case is unique in that the fistula formed as a result of complex atherosclerotic disease of the abdominal aorta, and not from an aneurysm.
authors: Department of General Surgery and Trauma Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. mikloshbala@gmail.com
authors: Miklosh
authors: M
authors: Bala
authors: Jacob
authors: J
authors: Sosna
authors: Liat
authors: L
authors: Appelbaum
authors: Eran
authors: E
authors: Israeli
authors: Avraham-I
authors: AI
authors: Rivkind
mesh_terms: D001018:Aortic Diseases / Q000175:diagnosis / Q000473:pathology; D004378:Duodenal Diseases / Q000175:diagnosis / Q000473:pathology; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016157:Vascular Fistula / Q000175:diagnosis / Q000473:pathology