PRIMARY AORTOGASTRIC FISTULA - A COMPLICATION OF RUPTURED AORTIC-ANEURYSM

An aortogastric fistula which resulted from rupture of an atherosclero tic aneurysm of the descending and supraceliac aortic segments is repo rted. The diagnosis was suspected preoperatively on the basis of CT an d angiographic examinations. Vascular replacement was accomplished wit hout difficulty, but a fatal outcome eventually occurred because of fa ilure of local repair of the gastric defect. Relevant literature on pr imary aortoenteric fistulas has been reviewed, with particular emphasi s on reports detailing management of the alimentary tract perforations . We now believe that resection should be strongly considered in situa tions where both resection and local repair of the enteric defect are options.