Related Experiment Video
Updated: Aug 29, 2026

Technical Aspects of the Mouse Aortocaval Fistula
Published on: July 11, 2013
Unusual presentations of aorto-enteric fistula
Srihari Ramanujam1, Aaron Shiels, Gary Zuckerman
1Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri 63110, USA.
Background:
Aorto-enteric fistula is rare but can result in exsanguination without timely surgery or endovascular stent placement.
Methods:
Four cases of aorto-enteric fistula were reviewed in which the presentation was unusual and diagnosis difficult.
Observations:
The first patient had an aorto-sigmoid fistula in the setting of an aorto-bi-femoral graft. Two patients had a primary aorto-enteric fistula, one to the stomach from a suprarenal aortic aneurysm, and the other, to the duodenum in the setting of retroperitoneal spread of renal cancer. The aortoduodenal fistula recurred in the 4th patient within 3 months of surgical repair; this patient is the only one who survived long term.
Conclusions:
When presentation is atypical, the diagnosis of aorto-enteric fistula can be extremely difficult. Because investigative studies are not consistently useful in making a definitive pre-operative diagnosis, a strong index of clinical suspicion and a willingness to consider surgical exploration are essential for timely and successful management.
Related Concept Videos
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Aneurysm I: Introduction
Aneurysm III: Interprofessional Care
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Intestinal Obstruction I: Introduction
