Primary aortoduodenal fistula without abdominal aortic aneurysm in association with psoas abscess

Primary aortoenteric fistula (PAEF) is a communication between the aorta and the enteric tract without any previous vascular intervention, e.g., aortic grafting. Although rare, PAEF is a potentially lethal condition that requires a high index of suspicion and prompt surgical intervention. Most of the reported cases involve an abdominal aortic aneurysm. However, in this report, we describe a rare case of a primary aortoduodenal fistula in a nonaneurysmal aorta in association with a psoas abscess, which was treated successfully. At 2-year follow-up, the patient is alive without episodes of bleeding or fever.