Enigma of primary aortoduodenal fistula.
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.
Bala
Miklosh
M
Department of General Surgery and Trauma Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. mikloshbala@gmail.com
Sosna
Jacob
J
Appelbaum
Liat
L
Israeli
Eran
E
Rivkind
Avraham-I
AI
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