Case Report
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World J Gastroenterol. Jan 21, 2013; 19(3): 415-417
Published online Jan 21, 2013. doi: 10.3748/wjg.v19.i3.415
Primary aortoduodenal fistula: A case report
Abdu Hassan Alzobydi, Shaista Salman Guraya
Abdu Hassan Alzobydi, Department of Surgery, King Khalid Hospital, Najran 21431, Saudi Arabia
Shaista Salman Guraya, Department of Radiology, Taibah University, Almadinah Almunawwarah 41477, Saudi Arabia
Author contributions: Guraya SS contributed to drafting the report, analyzing the patient’s data and writing the paper; Alzobydi AH revised the paper and approved the final version to be published.
Correspondence to: Shaista Salman Guraya, FRCR, PhD, Cert MedEd, Assistant Professor, Department of Radiology, Taibah University, Almadinah Almunawwarah 41477, Saudi Arabia. drss76@yahoo.com
Telephone: +966-4-8460008 Fax: +966-4-8461407
Received: July 26, 2012
Revised: September 12, 2012
Accepted: October 19, 2012
Published online: January 21, 2013
Processing time: 179 Days and 16.4 Hours
Abstract

Primary abdominoaortic fistula is an extremely rare cause of upper gastrointestinal (GI) bleeding. The diagnosis is frequently delayed due to the rarity of the disease and low index of suspicion by physicians. A range of invasive and non-invasive diagnostic tools are available, but helical computer tomography (CT) remains the mainstay. Surgery offers the only hope for survival. This case report presents a 47-year-old male with massive upper GI bleeding. Various diagnostic tests and an exploratory laparotomy failed to identify the diagnosis. Later, a primary aortoduodenal fistula was confirmed by CT scan which necessitated surgical repair of the fistula and a Goretex graft for the abdominal aortic aneurysm. The patient made an uneventful recovery and remained well to the first postoperative visit in the clinic 2 wk after surgery.

Keywords: Abdominal aortic aneurysm; Aortoduodenal fistula; Computer tomography; Mycotic aneurysm