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CRITICAL CARE AND TRAUMA

Primary Aortoenteric Fistula: Should Enhanced Computed Tomography be Considered in the Diagnostic Work-Up?

Alice Wood, BSc, MBBS^*, Si-Mhamed Bendjelid, MD, and Karim Bendjelid, MD, MS^*

*Division of Surgical Intensive Care, Department APSIC, University Hospitals of Geneva, Switzerland; Department of Radiology, Hospital of Moulins, France

Address correspondence and reprint requests to Karim Bendjelid, MD, MS, Surgical Intensive Care Division, University Hospital of Geneva, CH-1211, Geneva 14, Switzerland. Address e-mail to karim.bendjelid{at}hcuge.ch.

We present the case of a 66-yr-old woman who was admitted to a surgical intensive care unit with life-threatening rectal bleeding. Despite the use of angiography and repeated computed tomography scans, the diagnosis of a primary aortoduodenal fistula secondary to an abdominal aortic aneurysm was not made, leading to a delay in diagnosis until the time of surgery. The reliability of radiological investigations and the importance of being alert to the possibility of this extremely rare condition are discussed.

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				Q. D. M. Vu, C. O. Menias, S. Bhalla, C. Peterson, L. L. Wang, and D. M. Balfe Aortoenteric Fistulas: CT Features and Potential Mimics1 RadioGraphics, January 1, 2009; 29(1): 197 - 209. [Abstract] [Full Text] [PDF]