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Published on: July 11, 2013

Upper gastrointestinal bleeding due to primary aortoenteric fistula

S Gourgiotis1, P Moustafellos, A Zavos

  • 1Hepatobiliary and Pancreatic Surgery Department, Royal London Hospital, UK. drsgourgiotis@tiscali.co.uk

Chirurgia (Bucharest, Romania : 1990)
|February 8, 2007
PubMed

Primary aortoenteric fistula (PAEF) is a rare but clinically important cause of catastrophic gastrointestinal bleeding. "Herald bleeding" is a characteristic symptom which refers to specific case of upper gastrointestinal bleeding that stop temporarily spontaneously and then proceeds to massive bleeding. We present the case report of a 55-year-old male with PAEF who was admitted due to upper gastrointestinal bleeding. Endoscopic studies were unremarkable and patient underwent exploratory laparotomy. The postoperative course was uneventful. A high index of suspicion, early diagnosis and prompt appropriate surgical intervention are crucial for survival of patient with PAEF. Gastrointestinal bleeding combined with a negative endoscopy suggests PAEF. Endovascular operation is an attractive treatment option.

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