ABSTRACT
A primary aortoenteric fistula is a rare, life-threatening cause of gastrointestinal bleeding. Primary aortoenteric fistula results most commonly from an abdominal aortic aneurysm, with the fistula forming most often between the aorta and the third portion of the duodenum. Often, the classic triad of abdominal pain, gastrointestinal bleeding, and pulsatile mass is absent. A heraldic bleed frequently precedes lethal exsanguination from a primary aortoenteric fistula. Patient survival is dependent on prompt diagnosis and emergent therapeutic laparotomy.
Subject(s)
Aortic Aneurysm, Abdominal/complications , Duodenal Diseases/complications , Gastrointestinal Hemorrhage/etiology , Intestinal Fistula/complications , Vascular Fistula/complications , Aged , Aortic Aneurysm, Abdominal/diagnostic imaging , Duodenal Diseases/diagnostic imaging , Emergencies , Humans , Intestinal Fistula/diagnostic imaging , Male , Tomography, X-Ray Computed , Vascular Fistula/diagnostic imagingABSTRACT
We present the case of a 74-year-old male with chest pain, dyspnea, and syncope secondary to an acute pulmonary embolism complicated by a patent foramen ovale with straddling thrombus and paradoxical embolization. We review the literature with specific focus on the pathogenesis and acute treatment of this life-threatening occurrence.
