Abdominal Aortic Graft Causing Recurrent Aortoduodenal Fistula as a Rare Cause of Gastrointestinal Bleeding: Case Report

摘要

Background: Aortoenteric fistula( AEF) is a rare and deadly vascular complication usually secondary to aortic aneurysmal graft repair causing massive bleeding. Recurrent AEF, years after the initial repair, is an even rarer occurrence. Case presentation: We present a case of a 58 year old male with history of abdominal aortic aneurysm, who was brought to the emergency department (ED) after being found unresponsive with a visual approximation by EMT of 500ml of bright red blood per rectum. Unlike many previous case reports our patient’s recurrent fistula occurred years after second repair in 2012. Conclusions: Although rare, abdominal aortic aneurysm (AAA) repair can form enteric fistula causing massive bleeding which is a medical emergency. Patient can present with hemodynamic instability. Urgent vascular imaging and repair is necessary for the management.