Aorto-duodenal fistula

Case contributed by Dr Lawrence Chia Wei Oh

Presentation

Haematemesis

Patient Data

Age: 50
Gender: Female
Modality: CT

This CT abdomen demonstrated an infrarenal saccular abdominal aortic aneurysm. It has a thick and irregular wall with surrounding fat stranding. The body of the aneurysm noted to be abuting the third and fourth part of duodenum. The stomach and duodenal also noted to be significantly distended with fluid  These findings are consistent with aorto-duodenal fistula.  

Case Discussion

This patient has a past history of aorto-femoral bypass graft infection which was subsequently removed in surgery. The aorto-duodenal fistula is presumably secondary to previous chronic aorta infection/inflammation.

Thus, an aorto-duodenal fistula should always be suspected in patients who have undergone aortic graft surgery and present with haematemesis. 

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Case Information

rID: 25668
Case created: 2nd Nov 2013
Last edited: 26th Oct 2015
System: Vascular
Inclusion in quiz mode: Included

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