Secondary Aortoduodenal Fistula Presenting as Gastrointestinal Bleeding and Fungemia
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Univ Arizona, Internal MedIssue Date
2019-09-05Keywords
aortoenteric fistulagi bleed
candida
fungemia
revascularisation
aortic graft
polymicrobial
sepsis
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CUREUS INCCitation
Vegunta R, Vegunta R, Kutti Sridharan G (September 05, 2019) Secondary Aortoduodenal Fistula Presenting as Gastrointestinal Bleeding and Fungemia. Cureus 11(9): e5575. doi:10.7759/cureus.5575Journal
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© Copyright 2019 Vegunta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Collection Information
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.Abstract
A 55-year-old African American man with a history of abdominal aortic pseudoaneurysm repair presented to the ED with complaints of black-colored stools mixed with fresh blood and fever for three days duration. The exam was unremarkable except for abdominal bruits and pallor. CT angiogram showed perigraft fluid collection, bowel wall thickening, and loss of normal fat planes between the aorta and adjacent bowel at the level of the third portion of the duodenum. Polymicrobial infection was noted in the aortic graft and blood cultures grew Candida. The patient underwent urgent removal of the infected graft, duodenal repair along with appropriate antimicrobial therapy. He did well postoperatively and was discharged in a stable condition. Our case highlights the importance of maintaining a high index of suspicion of aortoenteric fistula (AEF) when a patient with a prior abdominal aortic graft develops gastrointestinal (GI) bleeding as this condition is universally fatal if unrecognized.Note
Open access journalISSN
2168-8184Version
Final published versionae974a485f413a2113503eed53cd6c53
10.7759/cureus.5575
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Except where otherwise noted, this item's license is described as © Copyright 2019 Vegunta et al. This is an open access article distributed under the terms of the Creative Commons Attribution
License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.