J Korean Soc Emerg Med.  2010 Jun;21(3):398-401.

A Rare but Fatal Instance of Gastrointestinal Bleeding: Primary Aortoenteric Fistula

• Park HK
• Choi BH
• Kwon MS
• Jung W
• Park SH
• Kim MC

Abstract

Primary aortoenteric fistula (PAEF) is a rare but catastrophic cause of gastrointestinal bleeding. The diagnosis of PAEF is difficult to make. The classic triad of symptoms, i.e. gastrointestinal bleeding, abdominal pain, and a pulsating abdominal mass is overemphasized, as it occurs in less than 11~25% of the patients. For two thirds of the patients, the diagnosis is made in the operating room. Endoscopic and radiographic studies are very helpful, but the absence of abnormalities can not exclude the diagnosis. PAEF is a clinical and surgical challenge associated with high mortality. A high index of suspicion, early diagnosis and prompt and appropriate surgical intervention are essential to patient survival. Two primary aortoenteric fistulas (aortoduodenal and aortoesophageal) cases are presented and the related literature are reviewed.

Keyword

Abdominal aorta; Intestinal fistula; Vascular fistula; Gastrointestinal hemorrhage; Abdominal aortic aneurysm

MeSH Terms

Abdominal Pain
Aorta, Abdominal
Aortic Aneurysm, Abdominal
Early Diagnosis
Fistula
Gastrointestinal Hemorrhage
Hemorrhage
Humans
Intestinal Fistula
Operating Rooms
Vascular Fistula