SIMULTANEOUS MANIFESTATION OF AN AORTOCAVAL AND AORTODUODENAL FISTULA

An unusual case of traumatic aortocaval and aortoduodenal fistula is p resented in which the two conditions occurred simultaneously. A 19-yea r-old man was admitted with acute upper gastrointestinal bleeding and a pulsatile abdominal mass. An aortography revelead an aortocaval fist ula and at the operation an aortocaval and aortoduodenal fistula was f ound. An aortocaval fistula can be discovered when a patient presents with an abdominal bruit or cardiomegaly with or without heart failure. The diagnosis of an aortoenteric fistula is difficult because of the subtleties in manifestation. The presence of an abdominal pulsatile ma ss and acute gastrointestinal bleeding should indicate that an aortoen teric fistula is possible.