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Canadian Journal of Gastroenterology
Volume 4 (1990), Issue 6, Pages 223-226
http://dx.doi.org/10.1155/1990/932101
Brief Communication

Aortoenteric Fistula Assocaited with Acute Myocardial Infarcation

Robert J Fingerote and Alan BR Thomson

Division of Medicine, Department of Gastroenology, University of Alberta, Edmonton, Alberta, Canada

Received 1 June 1990; Accepted 4 July 1990

Copyright © 1990 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 64-year-old male with a prior abdominal aortic graft for lower limb ischemia presented with melena and myocardial infarction. Despite aggressive investigation, an aortoenteric fistula was not diagnosed until after massive gastrointestinal hemorrhage. The patient's myocardial infarction may have heen precipitated by hypotension induced by hemorrhage through the aortoenteric fistula. Patients with prior abdominal aortic graft surgery presenting with gastrointestinal bleeding, abdominal pain or occult sepsis need to be aggressively investigated to determine whether an aortoenteric fistula is present. Laparotomy should be done in such patients if no cause for these symptoms can be determined.