title: Primary Aortoduodenal Fistula-A Case Report and a Review of the Literature.
abstract: Primary aortoduodenal fistula (PADF) is a direct communication between the abdominal aortic aneurysm (AAA) and duodenum. It is a rare entity and causes life-threatening gastrointestinal hemorrhage. Diagnosis requires a high index of clinical suspicion, and surgery offers the only hope for survival. We present a 73-year-old male who was initially admitted to the hospital with back pain and fever. He was diagnosed with pyelonephritis and treated with antibiotics. Computed tomography of the abdomen showed an AAA, but no aortoduodenal fistula was seen. Twelve days later, he was admitted to the hospital as he was hemodynamically unstable. An emergency laparotomy revealed a PADF which was repaired. The aortic aneurysm was repaired with an in situ silver graft and a bifemoral bypass. However, the patient developed severe graft infection and later succumbed.
authors.affiliation: Vascular Surgery Unit, Department of Surgery, Nordland Hospital, Bodo, Norway. Electronic address: mercy.verghese@gmail.com.
authors.forename: Mercy
authors.initials: M
authors.lastname: Varghese
authors.affiliation: Vascular Surgery Unit, Department of Surgery, Nordland Hospital, Bodo, Norway.
authors.forename: Geir Torvik
authors.initials: GT
authors.lastname: Jorgensen
authors.affiliation: Gastrointestinal Surgery Unit, Department of Surgery, Nordland Hospital, Bodo, Norway.
authors.forename: Camilla
authors.initials: C
authors.lastname: Aune
authors.affiliation: Department of Internal Medicine, Nordland Hospital, Bodo, Norway.
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Bergan
authors.affiliation: Gastrointestinal Surgery Unit, Department of Surgery, University Hospital of North Norway, Tromso, Norway.
authors.forename: Stig
authors.initials: S
authors.lastname: Norderval
authors.affiliation: Vascular Surgery Unit, Department of Surgery, Nordland Hospital, Bodo, Norway.
authors.forename: Jarl
authors.initials: J
authors.lastname: Moland
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D000072226:Computed Tomography Angiography; D004378:Duodenal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D016459:Prosthesis-Related Infections / Q000382:microbiology; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents