Primary Aortoduodenal Fistula: A Case Report and Current Literature Review

Primary aortoenteric fistula: is endovascular repair the prime option? A review of the literature

“…Computed tomography angiography is far more superior when compared to EGD, because not only is it a noninvasive method, but also it has a higher detection rate of 61%, sensitivity of 50-94%, and specificity of 85% [ 14 ]. Baril et al in their series with aortoenteric fistulae from 1997 to 2006 report a CT angiography sensitivity of 85.7% (12 of 14 patients) [ 8 ].…”

“…Moreover, CT angiography is a non-invasive method, with lower chances of dislodging the thrombus and re-bleeding [ 15 ]. Indirect signs of an aortoenteric fistula are the presence of air inside the aorta or the aneurysm sac, the elimination of the fat plane between aorta and duodenum, and bowel thickening, whereas the pathognomonic sign of PAEF is the extravasation of intravenous contrast to the intestinal lumen [ 14 ]. Another diagnostic tool is arteriography, even though it tends to be abandoned as a diagnostic process because the flow of the intravenous contrast is weak and the extravasation might not be identified [ 13 ].…”

A case report of primary aortoduodenal fistula: A forgotten cause of gastrointestinal bleeding

“…The incidence of PADF is very low, accounting for 0.04%-0.07%, and 53 cases of PADF were presented between 1951 and 2010 [6] . PADF is more common in males than females, with a median age of 70 and a range of 23-89 years old [7] .…”

Primary aortoenteric fistula: a rare complication of an eroding duodenal stent

“…This diagnostic sign should always raise suspicions for the presence of an aortoenteric fistula [ 2 ]. For the diagnosis of PAEF, EGD is necessary in order to exclude other causes of GI bleeding, although it has a 25% detection rate for PAEF [ 3 ]. In contrast, CT angiography is the ideal examination, not only because it has a high detection rate of 61%, but also because it is a non-invasive method without danger of dislodging a thrombus and rebleeding [ 4 ].…”

“…In contrast, CT angiography is the ideal examination, not only because it has a high detection rate of 61%, but also because it is a non-invasive method without danger of dislodging a thrombus and rebleeding [ 4 ]. Signs in the CT indicating PAEF are bowel thickening, free air in the aorta or the aneurysmatic sac, and intravenous contrast extravasation in the intestinal lumen [ 3 ]. The first successful endovascular repair of an aortoenteric fistula was described in 1997 and then the rapid development of interventional radiology established the endovascular approach as an optimal tool, supplanting the traditional open approach which was considered as the gold standard [ 5 ].…”