Abstract
Aorto-enteric fistula (AEF) is a well known complication after abdominal aortic surgery. However, it is often hard to diagnose because of its rare incidence and difficulty in detecting the bleeding point. Case 1: A 64-year-old man who had undergone aorto-bifemoral bypass grafting for aortic occlusion in April 2003 had abdominal pain and melena in August 2005. No cause was detected by gastrointestinal examinations, but he entered a state of shock after massive blood discharge and was performed emergency operation about 4 weeks later from his first episode of melena. Case 2: A 55-year-old man who underwent aorto-biiliac graft replacement for abdominal aortic aneurysm in October 1995 had abdominal pain and melena in July 2005. No cause was revealed by repeated gastrointestinal examinations. We suspected AEF because of the presence of pseudoaneurysm on computed tomography scan and performed on urgent operation about 5 weeks after his first abdominal pain. We should consider AEF if we encounter a patient with digestive bleeding of unknown cause after aortic surgery and decide on an emergency operation without a definitive diagnosis.
