Aortoenteric fistula

Case contributed by Dr Ian Bickle

Presentation

Abdominal pain for a week. Umbilical, lower abdominal and PR bleeding for 48 hours. Vomiting with occasional coffee grounds. Previous AAA repair.

Patient Data

Age: 75 years
Gender: Male
ct

6.2 cm infrarenal aortic aneurysm containing gas with direct fistulation to the third part of the duodenum into which contrast is extravasating.

Pleural plaques. Lungs clear.

Case Discussion

This is the kind of scan which makes even the coolest radiologist's heart skip a beat.

An absolute classic CT of an aortoenteric fistula.  Unless you are a vascular surgeon or interventional radiologist, you won't see too many of these in your career.

The patient died before any treatment could be commenced.

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