Aorto-digestive fistulae

On the basis of a case of aorto-duodenal fistula due to fissuration of a tuberculous sub-renal aneurysm, the authors review the difficult question of primary and secondary aorto-digestive fistulae. Primary fistulae are due to the rupture of an artheromatous or infectious aneurysm. The latter possibility must always be borne in mind. Aneurysms secondary to an aortic suture are more common in practice. There is also often a troublesome infectious element, requiring axillobifemoral bypass prior to treatment of the aneurism itself.