Case Report; Primary Aortoenteric Fistula Due to Plum Kernel

Abstract

Introduction: Aortoenteric fistulas are defined as an abnormal connection between the aorta and any portion of the gastrointestinal tract. It can occur after aortic repair surgery or spontaneously (primary). The common clinical features of primary aortoenteric fistula are upper gastrointestinal bleeding, abdominal pain, and pulsatile abdominal mass. The reasons are inflammatory destruction of an aortic aneurysm, infection, tumors and ingestion of foreign bodies. 
 We represent a case of a primary aortoenteric fistula due to plum kernel which is rarely seen.
 Case Report: A 76-year-old man admitted to emergency department with abdominal pain. On computed tomography angiography, there was hypodense restricted lesion with widespread air image which was located around the abdominal aorta. It was determined that abdominal aorta is surrounded by organised hematoma. A plum kernel, was detected in the operating room, was the reason for the aortoenteric fistula. Graft was placed in the abdominal aorta. He died in the first day after surgery.
 Conclusions: Primary aortoenteric fistulas should be considered in differential diagnosis of abdominal pain, upper gastrointestinal bleeding and shock in patient with aortic aneurysm. Kernels of any fruit considered to be harmless just as plum kernel and should be noted that may cause aortoenteric fistula.