Primary aortoduodenal fistula caused by severe atherosclerosis, not by aneurysm.
Abstract
Primary aortoduodenal fistula is an uncommon cause of massive upper gastrointestinal hemorrhage usually due to pressure erosion of an abdominal aortic aneurysm into the third portion of the duodenum. This report describes a case of a 59-year-old man who died of massive gastrointestinal hemorrhage due to a primary aortoduodenal fistula. This case is unique in that the fistula formed as a result of complex atherosclerotic disease of the abdominal aorta, with adventitial chronic inflammation and foreign body reaction against atheromatous plaque, and not from an aneurysm. We were unable to identify any other reports of aortoduodenal fistulas developing spontaneously in the absence of aneurysmal disease of the aorta.
Type
Department
Description
Provenance
Citation
Permalink
Collections
Scholars@Duke
David Michael Gallagher
I am currently the Chief Medical Officer at Duke University Hospital. As CMO I am a member of the senior leadership team that positively impacts the strategies, goals, and objectives at our hospital. I also help support Duke Clinical Automated Laboratories in a clinical consultant role. I am a Professor of Medicine at Duke University. My faculty career track is as a Clinician Leader – Administrator with an emphasis on Clinical Practice Advancement. I have 25+ years of physician leadership experience with previous roles as Chief of Duke Hospital Medicine Programs and Associate CMO of Duke University Hospital. As a clinically active hospitalist, I actively teach learners as an attending physician for Duke Hospital General Medicine Teaching Services caring for patients at DUH and other venues. I am board certified by the American Board of Internal Medicine with a Focused Practice in Hospital Medicine, current in that board’s Maintenance of Certification Program, and have achieved the designation and recognition as a Senior Fellow in Hospital Medicine through the Society of Hospital Medicine. The themes of my scholarly output include readmissions reduction, venous thromboembolism risk in hospitalized older adults, physical activity in hospitalized older adults, mentorship programs for hospitalists, quality improvement teaching to residents, and hospitalist workflow improvements.
My Twitter handle is @DGallagherMD
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.