Table 1.
Presentation and outcomes of aortoenteric fistulae.
Case # | Presentation | Initial evaluation | Further evaluation/diagnosis | Outcome |
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(1) 59 M | UGI bleeding | UGI endoscopy: negative | Repeat study 2 months later showed infected graft in duodenum | Excision of infected graft; gastrojejunostomy |
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(2) 83 F | Fever, coffee-ground emesis, bright red blood per rectum | UGI endoscopy: negative | Episode of rebleeding prompts repeat endoscopy, which shows pulsating duodenal clot. CT reveals gas around aortic graft | Hospital death |
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(3) 65 M | Massive hematemesis | Emergent laparotomy | Intraoperative findings: fistula with paraaortic abscess eroding aortic and duodenal wall | Unsuccessful resuscitation |
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(4) 71 M | Coffee-ground emesis, normal hemoglobin | UGI endoscopy: nonbleeding graft in the 3rd portion of duodenum | Emergency laparotomy scheduled | Exsanguination en route to OR |
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(5) 85 M | Fever, shaking chills | Blood cultures positive for C. albicans and streptococcus spp. | CT revealed periaortic graft gas | Excision of infected graft; right aortofemoral bypass graft |