Primary aortoduodenal fistula. A rare cause of acute gastrointestinal hemorrhage.

Abstract

SPONTANEOUS or primary aortoenteric fistula is an uncommon aortomality. It has a considerably greater incidence as a complication of reconstructive aortic surgery. The first report of successful surgical salvage of a patient with primary aortoduodenal fistula appeared in 1961. 1 Preservation of the life of patients with either primary or secondary aortoduodenal fistula depends on prompt diagnosis and treatment. 2-6 The increasing incidence and possibility of successful surgical treatment suggest that this abnormality can no longer be considered a rare clinical curiosity with an obligatory fatal outcome. While the various roentgenographic manifestations of abdominal aortic aneurysm have been reviewed in the literature, 7 there apparently are no reports of the roentgenographic appearance of aortoduodenal fistula on gastrointestinal examinations. We have had the opportunity to perform a gastrointestinal examination on two patients with primary aortoduodenal fistula. Unfortunately, of the improbability of occurrence of primary fistula prevented the diagnosis, although it was