Aorto‐duodenal Fistula: Multidetector Computed Tomography and Gastroduodenoscopy Findings of a Rare Cause of Upper Gastrointestinal Hemorrhage

Abstract

An aorto-enteric fistula is a serious complication of abdominal aortic aneurysm. Acute upper gastrointestinal bleeding may be a life-threatening condition that calls for immediate diagnosis and action. Morbidity and mortality remain high despite progress in diagnosis and therapeutic procedures. In the literature, the aorto-enteric fistula diagnostic suspicion by multidetector computed tomography scan is assumed on the basis of the interruption of the aortic wall, with the presence of duodenal gas situated to tightened contact with the aorta. We report a patient with an aorto-duodenal fistula associated with inflammatory abdominal aortic aneurysm detected by gastro-duodenoscopy and multidetector computed tomography scan, with gas found in the lumen of the abdominal aorta, between the aneurysm wall and the thrombus.

Endovascular treatment for secondary aortoduodenal fistula

“…Multiple diagnostic modalities are available to aid the diagnosis of ADF. The combination of upper endoscopy and contrast‐enhanced CT scan is the best diagnostic approach . Upper endoscopy is generally regarded as the primary investigation for its ability to perform quickly.…”

“…The combination of upper endoscopy and contrast-enhanced CT scan is the best diagnostic approach. 12 Upper endoscopy is generally regarded as the primary investigation for its ability to perform quickly. Barry et al stated that the use of endoscopy is useful in identifying ADF.…”