Spontaneous Aortoduodenal Fistula

Abstract

Two further cases, 1 fatal and 1 with long-term recovery, of patients treated surgically for spontaneous aortoduodenal fistula are reported, bringing the total number of published operations to 20. Thirty-six further examples of the lesion which were not treated by operation have been reported since 1957. Of a wide variety of causes for this lesion, the commonést is arteriosclerotic aneurysm of the aorta. The association of recurrent gastroduodenal haemorrhage with severe pain and collapse may indicate this lesion, and the treatment should be surgical. Control of the aorta proximal to the fistula is the essential first step in prosthetic grafting of the aorta and closure of the duodenum. Otherwise, spontaneous aortoduodenal fistula is uniformly fatal.