Abstract
An aorto-duodenal fistula (ADF) is rare, but it can cause lethal massive gastrointestinal tract bleeding and sepsis. An ADF is a direct communication between the aorta and duodenum, most commonly due to surgical repair of a prior aortic aneurysm (secondary ADF). Primary ADF rarely occurs as the spontaneous development of a communication because of an abdominal aortic aneurysm (AAA), trauma, tumor, and so on. A case of a 68-year-old man with massive hematemesis and loss of consciousness after a traffic accident is reported. After diagnosis of primary ADF on enhanced computed tomography and upper gastrointestinal endoscopy, the patient underwent immediate stent-graft repair due to his pre-shock state. After surgery, he received long-term treatment with antibiotics for more than 1 year. Endovascular stent-grafting with long-term antibiotic therapy may be effective for maintaining long-term remission in the management of patients with an ADF.
