Primary aorto-enteric fistulae are rare, mostly described as atypical
first manifestation of an abdominal aortic aneurysm. Spread of electiv
e aortic surgery led to increased appearance of secondary aorto-enteri
c fistulae as a typical postoperative complication. Gastrointestinal b
leeding with endoscopical unclear findings in a patient with aortic an
eurysm or history of aortic repair points towards an aorto-enteric fis
tula. While preoperative diagnosis is not possible in most instances,
the proof of an anastomotic aneurysm and/or aortic graft infection har
dens the suspected diagnosis of an aorto-enteric fistula decesively. T
he finding of coincidential mucosal lesions at gastroscopy may not mis
lead to give up the exclusion of an aorto-enteric fistula, possibly by
explorative laparotomy, if suspicion is well-founded. In the present
article nine cases of aorto-enteric fistulae treated at the Surgical U
niversity Clinic Wurzburg between 1982 and 1993 are analyzed retrospec
tively. Topical questions of diagnosis and therapy are discussed.