Alternate bleeding sites in suspected graft-enteric fistula

Nine cases of suspected aortoenteric fistula in patients with previous aortic reconstructive surgery and gastrointestinal bleeding collected over 5 years were reviewed. Five cases had angiographic evidence of a fistula, later proven at surgery. One patient had a negative angiogram but a fistula was found at surgery. In two cases angiography demonstrated different bleeding sites and in one patient a bleeding source was found by a nonangiographic method. Therefore three (33%) of nine patients had sources of gastrointestinal bleeding other than aortoenteric fistula.