Korean J Helicobacter Up Gastrointest Res.  2012 Mar;12(1):50-53. 10.7704/kjhugr.2012.12.1.50.

A Case of Primary Aortoenteric Fistula Mimicking Duodenal Subepithelial Tumor

• Song EM
• Shim KN
• Kang HW
• Kwon KJ
• Choi JY
• Kim SE
• Jung HK
• Jung SA

• KMID: 2305181
• DOI: http://doi.org/10.7704/kjhugr.2012.12.1.50

Abstract

Primary aortoenteric fistula is a fatal condition which poses a considerable diagnostic challenge because of its infrequency and nonspecific presentation. Here, the authors report the case of an 83-year-old man who presented with hematemesis and melena. During endoscopy, a 3 cm sized subepithelial mass with central ulceration was found in the second portion of the duodenum. At first, bleeding from a duodenal subepithelial tumor, such as, gastrointestinal stromal tumor was suspected. An endoscopic hemostasis trial failed and computed tomography (CT) scan was performed prior to possible angiographic embolization. The CT scan revealed the mass lesion observed by endoscopy as an aneurismal dilatation with fistula formation to the distal second portion of the duodenum. The patient succumbed to hypovolemic shock while preparations were being made for emergency surgery. This case provides an example of a primary aortoenteric fistula mimicking a duodenal subepithelial tumor during endoscopy.

Keyword

Intestinal fistula; Hematemesis; Duodenal neoplasms

MeSH Terms

Aged, 80 and over
Dilatation
Duodenal Neoplasms
Duodenum
Emergencies
Endoscopy
Fistula
Gastrointestinal Stromal Tumors
Hematemesis
Hemorrhage
Hemostasis, Endoscopic
Humans
Intestinal Fistula
Melena
Shock
Ulcer