title: Tuberculous aorto-duodenal fistula: a rare cause of upper gastrointestinal bleeding.
abstract: Aorto-enteric fistulas are rare and are associated with significant mortality. Infective causes usually occur within the setting of post-graft repair. Aorto-enteric fistula secondary to tuberculosis is extremely rare despite the high prevalence of this infection. Unfortunately, the diagnosis is often not suspected until surgery or at post-mortem. We report a case of an elderly Malay man presenting with massive gastrointestinal bleeding secondary to a tuberculous aorto-duodenal fistula in association with a saccular abdominal aortic aneurysm. This was successfully managed with an aortobifemoral graft repair and standard anti-tuberculous treatment for six months. A literature review of this rare condition is presented.
authors.affiliation: Gastroenterology Unit, Internal Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, BA 1710, Brunei Darussalam.
authors.forename: V H
authors.initials: VH
authors.lastname: Chong
authors.forename: P U
authors.initials: PU
authors.lastname: Telisinghe
authors.forename: C F
authors.initials: CF
authors.lastname: Chong
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000473:pathology* / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery; D004378:Duodenal Diseases / Q000150:complications* / Q000601:surgery; D004386:Duodenum / Q000473:pathology / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications* / Q000601:surgery; D008297:Male; D014385:Tuberculosis, Gastrointestinal / Q000150:complications*