Aorto-Enteric Fistula Associated with Aortic Dissection

Abstract 

Primary aorto-enteric fistula (PAEF) is usually due to erosion by atherosclerotic aneurysm. We report a case of PAEF secondary to a previously unrecognised focal abdominal aortic dissection. A 66-year-old man was brought to the casualty department with shock and acute-on-chronic back pain. Following resuscitation, he deteriorated further secondary to frank haematemesis. A prompt contrast enhanced CT scan was performed, and aortic dissection with aorto-duodenal fistula was diagnosed and operated on. To our knowledge, there are no previous reports of penetrating, transmural PAEF secondary to abdominal aortic dissection.

Keywords: Primary aorto-enteric fistula, Aortic dissection, Abdominal aortic aneurysm