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Aortoenteric fistula in a 21-year-old.

G T Billingham¹, H A Bessen

¹Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance 90509.

The Journal of Emergency Medicine

|September 1, 1991

Summary

Aortoenteric fistula, a rare complication of aortic repair, can occur years after surgery. This case highlights the importance of considering this diagnosis in young patients with gastrointestinal bleeding and prior aortic surgery.

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Area of Science:

Vascular Surgery
Gastroenterology
Diagnostic Imaging

Background:

Aortoenteric fistula is a rare but life-threatening complication, often associated with prosthetic aortic grafts or abdominal aortic aneurysms.
Diagnosis can be challenging due to non-specific symptoms and the need for advanced imaging techniques.

Observation:

A 21-year-old male presented with recurrent severe gastrointestinal hemorrhage.
The patient had a history of aortic repair following a stab wound four years prior.
Initial endoscopic and radiologic studies were negative, delaying diagnosis.

Findings:

The patient was diagnosed with an aortoduodenal fistula, a direct connection between the aorta and the duodenum.
This represents the youngest reported case of aortoenteric fistula following aortic surgery.
The fistula originated from the site of previous aortic repair.

Implications:

Clinicians should maintain a high index of suspicion for aortoenteric fistula in patients with gastrointestinal bleeding and a history of aortic surgery, irrespective of age.
Diagnostic strategies may need to be reconsidered in cases with negative initial workups.
Early recognition and surgical intervention are critical for managing this potentially fatal condition.

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