Introduction:

Aortoenteric fistulas are a rare cause of gastrointestinal bleeding. The generally ominous prognosis depends on high clinical suspicion and timely diagnosis.

Objective:

To present a case of gastrointestinal hemorrhage for aortoenteric fistula diagnosed and treated.

Case presentation:

The case is reported of a 72-year-old man who received surgery after the diagnosis of massive gastrointestinal bleeding during the preoperative period. However, the diagnosis of the fistula was made intraoperatively, without observing aneurysmal dilation, but an atheromatous aorta and an inflammatory process leading to the fistula instead. Urgent surgical repair was performed with repair of anterior infrarenal aorta near the bifurcation and resection of the terminal ileum with end-to-side ascending ileostomy.

Discussion:

Aortoenteric fistulas are a potentially fatal cause for gastrointestinal bleeding. Diagnosis continues to be a challenge due to its nonspecific presentation and should always be considered for any case of unexplained gastrointestinal bleeding. There are several options for surgical management that must be analyzed case by case, without delaying repair.

Conclusions:

Primary aortoenteric fistula is a rare cause for gastrointestinal bleeding, which every doctor and surgeon must take into account when dealing with a patient with digestive bleeding of an unspecified cause.

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