Primary aortoduodenal fistula: Pitfalls and success in the endoscopic diagnosis

Primary Aorto-duodenal Fistula: A Rare but Potentially Fatal Cause of Gastrointestinal Bleeding

“…1,4,7 Despite the communication between the aorta and the digestive tract, fever and other signs of systemic infection are rare. There is usually an initial self-limiting hemorrhage (sentinel hemorrhage), which in most cases is followed by a massive hemorrhage that occurs some hours or even a month later.…”

The cause of intestinal bleeding cannot be missed: the case of primary aortic-enteric fistula

“…gastrointestinal hemorrhage, abdominal mass and abdominal or back pain is uncommon. [4][5][6][7] As in our case, the typical bleeding pattern associated with PAEF is usually intermittent, starting with a brief herald bleeding followed by major gastrointestinal hemorrhage having often a fatal outcome. 8 Even if the preoperative examinations are often not helpful and can lead to delayed diagnosis and surgery, we suspected the presence of PAEF by a simple imaging technique such as transabdominal ultrasonography associated with echo-color-Doppler and the final diagnosis was made by contrastenhanced computed tomography that showed the presence of abdominal aneurysm, the linkage between the aneurysm and the duodenum and the presence of blood in the intestinal lumen.…”

Aorto-Enteric Primary Fistula on Remote Endovascular Aneurysm Repair

“…However, an aortoduodenal fistula is rarely appreciable using endoscopic examination, and, in case of the presence of gastritis or ulcers, cannot exclude the presence of a fistula (24,25).…”