Under the Radar: A Case Report of a Missed Aortoenteric Fistula

Abstract

Introduction: An aortoenteric fistula (AEF) is an abnormal connection between the aorta and the gastrointestinal tract that develops due to a pathologic cause. It is a rare, but life-threatening, cause of gastrointestinal (GI) bleeding. Although no single imaging modality exists that definitively diagnoses AEF, computed tomography angiography (CTA) of the abdomen and pelvis is the preferred initial test due to widespread availability and efficiency. Case Report: Many deaths occur before the diagnosis is made or prior to surgical intervention. We describe a case of a patient with a history of aortic graft repair who presented with active GI bleeding. Conclusion: Although CTA can make the diagnosis of AEF, it cannot adequately rule it out. In patients with significant GI bleeding and prior history of aortic surgery, vascular surgery should be consulted early on, even if CTA is equivocal.

Primary Aortoenteric Fistula in a Patient With Prior Abdominopelvic Surgery and Opioid-Induced Constipation

“…AEF is a rare condition, with about 0.007 incidences per million people [5]. AEF is classified into two types: primary and secondary.…”

Aortoenteric Fistula: A Differential Diagnosis of Anemia

“…An aortoenteric fistula (AEF) is a rare and life-threatening condition characterized by an abnormal connection between the aorta and the gastrointestinal tract, with an incidence of approximately 0.007 per million people [ 1 ]. This connection can cause significant bleeding, which can lead to severe hemorrhage and death.…”