Aorto-duodenal fistulae (ADF) are the most frequent aorto-enteric fistulae (80%), presenting with upper gastrointestinal bleeding. [ncbi.nlm.nih.gov]

An endoluminal aortic prosthesis infection presenting as pneumoaorta and aortoduodenal fistula. [tmu.pure.elsevier.com]

• Pallor

  The following day, the patient’s lower extremities had increased pallor and he underwent axillofemoral and femoral-femoral bypass grafting. He went into cardiac arrest perioperatively and died. Figure 1. [acgcasereports.gi.org]

  On systemic examination, the patient was found to have pallor, feeble pulse and was hemodynamically unstable with a blood pressure (BP) of 80/50, heart rate (HR) of 138 beats per minute, C reactive protein (CRP) of 96 and hemoglobin (Hb) of 6.2gm%. [tropicalgastro.com]

  Case presentation We report a 65-year-old Sri Lankan man who was hospitalised with recent onset low backache and severe pallor (haemoglobin, 6 gm/dl). [casesjournal.biomedcentral.com]

• Splenectomy

  Review of his medical history was notable for peripheral arterial disease, an AAA previously measuring 4.4 cm in size, a left iliac aneurysm measuring 1.6 cm and a splenectomy for lymphoma (unknown type). [casereports.bmj.com]

• Hematemesis

  After the fistula was closed, the patient repeated hematemesis and anal bleeding. She died of acute hemorrhagic shock, in spite of three operations including axillo-femoral bypass. [jstage.jst.go.jp]

  A 53-year-old female patient suffered from massive hematemesis and shock due to an iatrogenic aortoduodenal fistula which was made during a laparoscopic total colectomy. [ncbi.nlm.nih.gov]

• Melena

  Three years after operation, melena was caused by perforation of the duodenal wall by a pseudoaneurysm at the proximal graft anastomosis. The pseudoaneurysm was treated by transluminal endovascular grafting. [ncbi.nlm.nih.gov]

  The patient was a 44-year-old woman who repeated intermittent hematemesis and melena after hysterectomy, para-aortic lymph node dissection, and subsequent radiotherapy. Angiography revealed no bleeding point. [jstage.jst.go.jp]

  Bleeding manifests as melena (81%) and, rarely, hematochezia (6%), or hematemesis (0%). [acgcasereports.gi.org]

• Loss of Appetite

  She was later discharged again on conservative treatment, and followed up at the outpatient clinic, but nine months postoperatively, was readmitted complaining of loss of appetite and abdominal pain. [ncbi.nlm.nih.gov]

  Furthermore, 30- day postoperatively, the patient complained of loss of appetite and abdominal distension due to ascites ( Figures 2A and 2B ). [omicsonline.org]

• Abdominal Bruit

  An aortocaval fistula can be discovered when a patient presents with an abdominal bruit or cardiomegaly with or without heart failure. The diagnosis of an aortoenteric fistula is difficult because of the subtleties in manifestation. [ncbi.nlm.nih.gov]

  Physical examination confirmed a faint mesogastric bruit associated with an abdominal pulsatile mass. Melenic stool was found in the rectal vault on rectal examination. [academic.oup.com]

• Vascular Disease

  Patients with peripheral vascular disease presenting with pyomyositis may be difficult to distinguish from those with critical ischemia or synthetic graft sepsis. [ncbi.nlm.nih.gov]

  Case Report A 66-year-old white man with hypertension, hyperlipidemia, COPD, lung cancer, and aortoiliac bypass graft placed 6 years prior for peripheral vascular disease, presented with 3 days of melena and syncopal events associated with bowel movements [acgcasereports.gi.org]

  Other causes of a primary aortoenteric fistula stem from some type of inflammation such as syphilis, tuberculosis, mycotic infection or collagen vascular disease. [abc.go.com]

  His past medical history included diabetes mellitus, chronic kidney disease, peripheral vascular disease and surgery for repair of ruptured aortic aneurysm 6 weeks ago. Systemic examination, including per rectal examination, was normal. [bjmp.org]

  Cardiovascular and vascular disease of the aorta. Philadelphia: WB Saunders; 1997:126-52. [ Links ] 23. Walker WE, Cooley DA, Duncan JM, Hallman GL, Ott DA, Reul GJ. [scielo.br]

• Heart Murmur

  Physical examination revealed a pale conjunctiva, no heart murmur, clear breathing sound, old operative scar over middle abdomen, and hypoactive bowel sound with tenderness over the periumbilical region. [bmccardiovascdisord.biomedcentral.com]

• Tingling

  Case presentation A man aged 78 years presented to the emergency room at an outside hospital with symptoms of new-onset left lower extremity numbness, tingling and a presyncopal episode. [casereports.bmj.com]

• Forgetful

  In the current era with highly sophisticated imaging, it can be easy to forget that direct visualisation is sometimes the only form of direct evidence possible. [casereports.bmj.com]

A diagnostic workup was suggestive of a primary aortoduodenal fistula caused by erosion of an infrarenal abdominal aortic aneurysm. [ncbi.nlm.nih.gov]

As we stand now, the main diagnostic workup for suspected secondary AEF is influenced by the presence of active bleeding alongside hemodynamic instability. [ghrnet.org]

In stable patients with suspicion of an aortoduodenal fistula, workup includes gastroduodenoscopy aiming to visualize the full length of the duodenum ( Figure 5 ), CTA to assess for signs of graft infection and pseudoaneurysm formation, and sometimes [evtoday.com]

[…] vena cava for nutcracker syndrome Hybrid treatment of an ascending aortic pseudoaneurysm following multiple sternotomies Wakeup test decrease shunts insertion during carotid endarterectomy under general anesthesia Accuracy of FDGPETCT in the diagnostic workup [books.google.ro]

• Base Deficit

  His vital signs and base deficit normalised. He was kept on antibiotics for ischaemic colitis and low-dose heparin for suspected acute on chronic critical ischaemia of the left lower extremity. [casereports.bmj.com]

• Coxiella Burnetii

  We report a rare case of primary aortoduodenal fistula (ADF) secondary to a Coxiella burnetii (Q fever) infection in a patient with an abdominal aortic aneurysm. [uthscsa.influuent.utsystem.edu]

  We describe the clinical symptoms, diagnostic tools for detection of Coxiella burnetii infection and treatment. KEYWORDS: aorta abdominal aneurysm; chronic Q-fever; primary aortoduodenal fistula [ncbi.nlm.nih.gov]

The patient was a 58-year-old woman given curative treatment (pancreatectomy (body and tail) + intraoperative irradiation (25 Gy)) on the basis of a diagnosis of pancreatic carcinoma. [ncbi.nlm.nih.gov]

[…] changes Postendovascular stent Pathology Primary etiology: Abdominal aortic aneurysms, infectious aortitis, penetrating peptic ulcer, tumor invasion, radiation therapy Secondary etiology: Aortic reconstructive surgery most common Clinical Issues Very poor prognosis [sites.google.com]

CONCLUSION&58; Aorto-enteric fistulas are associated with a grave prognosis. Early diagnosis is crucial and extra vigilance should be taken in cases of inflammatory AAA. [ingentaconnect.com]

[…] retroperitoneal hematoma or hematoma within the bowel wall or lumen Secondary aortoenteric fistula increased perigraft soft tissue pseudoaneurysm formation disruption of aneurysmal wrap increased soft tissue between the graft and aneurysmal wrap Treatment and prognosis [radiopaedia.org]

Given poor prognosis family request, patient was transferred to hospice care. 3. Discussion SAEF occurs when there is an inappropriate communication between the aorta and adjacent GI tract causing massive bleeding. [article.sapub.org]

Early diagnosis and treatment can improve the prognosis, but a high index of clinical suspicion is required. [elsevier.es]

Atherosclerosis remains the most common etiologic factor, accounting for more than two-thirds of the cases reported. [ncbi.nlm.nih.gov]

Physician should consider the diagnosis of aortoduodenal fistula in patients with even mild upper gastrointestinal bleeding of uncertain etiology and abdominal pulsatile mass. [jstage.jst.go.jp]

Complications of Modern Renal Revascularization 288 14 The Diagnosis and Management of Aortic Bifurcation Graft Limb Occlusions 308 15 Problems Related to ExtraAnatomic BypassIncluding Axillofemoral Femorofemoral Obturator and Thoracofemoral Bypasses 323 Epidemiology [books.google.ro]

[…] hours/days/weeks later by catastrophic hemorrhage Abdominal/back pain, palpable and pulsatile mass Intermittent rectal bleeding and recurrent anemia Low-grade fever, fatigue, weight loss, leukocytosis Demographics Age: 55 and older Gender: M:F = 4-5:1 Epidemiology [sites.google.com]

This case report covers pathophysiology, diagnostic evaluation, and management of an aortoenteric fistula. [ncbi.nlm.nih.gov]

In Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management, edn 8 (1 vol) 757–777 ( Eds Feldman M et al .) [nature.com]

In this report five cases are described in which the diagnosis was established endoscopically, and the literature regarding the pathophysiology and natural history of this entity is reviewed. [link.springer.com]

Classification and pathophysiology of enterocutaneous fistulas. Surg Clin North Am 1996;76:1009–1018. 11. Sweeney MS, Gadacz TR. Primary aortoduodenal fistula: manifestation, diagnosis, and treatment. Surgery 1984;96:492–497. 12. [synapse.koreamed.org]

To prevent a high mortality rate, early diagnosis is necessary. Exploratory laparotomy is required for patients who are highly suspected of having an aortoduodenal fistula. [ncbi.nlm.nih.gov]

288 14 The Diagnosis and Management of Aortic Bifurcation Graft Limb Occlusions 308 15 Problems Related to ExtraAnatomic BypassIncluding Axillofemoral Femorofemoral Obturator and Thoracofemoral Bypasses 323 Epidemiology Microbiology Pathogenesis and Prevention [books.google.ro]

[…] to frequent vascular surgical and aortic reconstructive procedures, and has been reported in up to 5% of cases. 3 In 1963, Humphries et al 3 reported 70 cases of aortoenteric fistula after aortic surgery, including 26 cases of their own, noting that preventive [jamanetwork.com]

Functional outcome of hypogastric revascularisation for prevention of buttock claudication in patients with peripheral artery occlusive disease Endovascular treatment of traumatic thoracic aortic injuries short and mediumterm Followup The management of [books.google.es]