Aortoenteric fistula in a 21-year-old

We present the case of a 21-year-old male with recurrent, severe gastrointestinal hemorrhage, who eventually proved to have an aortoduodenal fistula. The fistula arose from an aortic repair done after a stab wound four years previously. The diagnosis of aortoenteric fistula was not initially suspected because of the patient's age, inability to provide details of his previous surgery, and false-negative endoscopic and radiologic studies. We believe that this is the youngest reported patient who developed an aortoenteric fistula after aortic surgery. The presence of an aortoenteric fistula should be suspected in any patient with a GI bleed and previous aortic surgery, regardless of the patient's age.