Primary aortoenteric fistula in the Emergency Department

• Published in: The Journal of emergency medicine Vol. 20; no. 1; pp. 25 - 27
• Main Authors: Mirarchi, Ferdinando L, Scheatzle, Mark D, Mitre, Ricardo J
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2001; Elsevier
• Subjects: abdominal aortic aneurysm; Aged; Aortic Aneurysm, Abdominal - complications; Aortic Aneurysm, Abdominal - diagnostic imaging; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Diseases of the aorta; Duodenal Diseases - complications; Duodenal Diseases - diagnostic imaging; Emergencies; Gastroenterology. Liver. Pancreas. Abdomen; gastrointestinal bleeding; Gastrointestinal Hemorrhage - etiology; herald bleed; Humans; Intestinal Fistula - complications; Intestinal Fistula - diagnostic imaging; lethal exsanguination; Male; Medical sciences; Other diseases. Semiology; primary aortoenteric fistula; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tomography, X-Ray Computed; Vascular Fistula - complications; Vascular Fistula - diagnostic imaging; lethal exsanguination; primary aortoenteric fistula; herald bleed; abdominal aortic aneurysm; gastrointestinal bleeding; Human; Aneurysm; Cardiovascular disease; Male; Fistula; Arterial disease; Vascular disease; Case study; Aortointestinal; Clinical management; Digestive diseases; Intestinal disease; Aorta; Complication; Elderly; Aortic disease
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/S0736-4679(00)00288-2

A primary aortoenteric fistula is a rare, life-threatening cause of gastrointestinal bleeding. Primary aortoenteric fistula results most commonly from an abdominal aortic aneurysm, with the fistula forming most often between the aorta and the third portion of the duodenum. Often, the classic triad of abdominal pain, gastrointestinal bleeding, and pulsatile mass is absent. A heraldic bleed frequently precedes lethal exsanguination from a primary aortoenteric fistula. Patient survival is dependent on prompt diagnosis and emergent therapeutic laparotomy.