Aortoduodenal fistula: endoscopic diagnosis

Aortoduodenal fistula has been reported as a complication in up to 4% of aortic aneurysm repairs, presenting as gastrointestinal bleeding of varying severity. Mortality of patients not operated on approaches 100%, and preoperative diagnosis is extremely difficult. In this report five cases are described in which the diagnosis was established endoscopically, and the literature regarding the pathophysiology and natural history of this entity is reviewed.