Angiographic signs of aortic graft-enteric fistulae

Angiograms of four patients with intestinal bleeding from aortic graft-enteric fistulae collected over 4 years have been reviewed. All showed a bulging dilatation of the graft and aortic anastomosis. False aneurysms of the proximal aortic anastomosis were demonstrated twice. A patent fistula was never demonstrated. Angiograms performed in the same period of 18 consecutive patients without fistulae, after aortic graft reconstruction, were reviewed for comparison. None of these displayed the bulging of the graft seen in the group of graft-enteric fistulae. Thus in a patient with gastrointestinal bleeding and a high suspicion of aortic graft-enteric fistula, the diagnosis is supported angiographically by the presence of this bulge.