aortoenteric fistula; aortoduodenal fistula

Epidemiology

• uncommon
• many patients have undergone aortic graft surgery 2 months to 8 years prior to presentation with an UGI bleed

Pathology

• potentially lethal cause of upper gastrointestinal (UGI) bleeding
• 90% are aortoduodenal fistulas

Clinical manifestations

• the classic presentation is a 'herald' bleed hours to weeks prior to a massive UGI hemorrhage

Diagnostic procedures

• esophagogastroduodenoscopy (EGD)

Radiology

• abdominal CT with contrast (first diagnostic test)
• CT angiography with delayed images (NEJM)
• angiography

Management

• surgery

More general terms

• arterial fistula
• intestinal fistula

Additional terms

• upper gastrointestinal hemorrhage