DOI: https://dx.doi.org/10.18203/2349-2902.isj20222243
Published: 2022-08-26

Primary aorto enteric fistula as a cause of massive upper gastro-intestinal bleed-a very rare case presentation

Rohith Mudadla, Harshit Kamal, Govind Purushothaman, Jeswanth Satyanesan

Abstract


Primary aortoenteric fistula (PAEF) is spontaneous development of communication between the native aorta and anywhere within the gastrointestinal tract. It is extremely rare and fatal condition which usually presents as a painless upper gastrointestinal bleed. This condition is often overlooked because of it's rarity and low index of suspicion by physicians despite the availability of a wide range of diagnostic tools. Computed tomography angiography (CTA) is the most common investigation done to diagnosis PAEF. This paper reports a case of 49 years old female with massive upper gastrointestinal (GI) bleeding. A PAEF was diagnosed by CTA which called for an emergency laparotomy with surgical repair of the fistula with a synthetic vascular bypass graft. The patient recovered well.


Keywords


PAEF, CTA, GI

Full Text:

PDF

References


Voorhoeve R, Moll FL, De Letter JA, Primary aortoenteric fstula:review of eight cases. Ann Vasc Surg. 1996;10(1):40-8.

Ghilardi G, Longhi F, Sgroi G, Primary aorto-enteric communication. Minerva Cardioangiol. 1994;42(5):233-7.

Song Y, Liu Q, Shen H. Diagnosis and management of primary aortoenteric fistulas-experience from eighteen patients. Surgery. 2008;143(1):43-50.

Brown PW, Sailors DM, Headrick JR, Burns RP. Primary aortojejunal fistula: a case report. Am Surg. 1999;65(2):139-41.

Salman M. Aneurysme de I’aorte ventrale mort gur rupture de le poche attriele dars le duodenum. Bull Soc Anat. 1843;18:283.

Malik MU, Ucbilek E, Sherwal AS. Critical GI bleed due to secondary aortoenteric fistula J. 2015;5(6):29677.

Saers SJ, Scheltinga primary aortoenteric fstula. Br J Surg. 2005;92(2):143-52.

Skourtis G, Papacharalambous G. Primary aortoenteric fistula due to underlying septic aortitis. Ann Vasc Surg. 2010;24(6):825.e7-11.

Biro G, Szabo G, Fehervari M. outcome after open surgical management of SAEF Langenbecks Arch Surg. 2011;396(8):1221-9.

Thompson WM, Jackson DC, Johnsrude IS: Aortoenteric and paraprosthetic-enteric fistulas: Radiologic findings. AJR Am Roentgenol. 127:235:1976.

Jiang C, Chen X, Li J. Case of successful managed secondary aorto enteric fistula with GI bleed and retroperitoneal abscess in an elderly patient. Medicine (Baltimore). 2018;97(24):e11055.