An autopsy case of a primary aortoenteric fistula: A pitfall of the endoscopic diagnosis

作     者：Yoko Ihama Tetsuji Miyazaki Chiaki Fuke Yasushi Ihama Ryoji Matayoshi Hiroshi Kohatsu Fukunori Kinjo 

作者机构：Department of Legal Medicine School of Medicine University of the RyukyusOkinawa 903-0215 Japan Department of Endoscopy University Hospital University of the Ryukyus Okinawa 903-0215 Japan Department of Internal Medicine Okinawa Red Cross HospitalOkinawa 900-8611 Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2008年第14卷第29期

页      面：4701-4704页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Author contributions: Ihama Y  Miyazaki T  Fuke C performed the medico-legal autopsy and wrote this paper Ihama Y  Matayoshi R  Kohatsu H  Kinjo F contributed clinically to this work 

主　　题：Primary aortoenteric fistula Gastrointestinal bleeding Herald bleeding Misleading Medico-legalautopsy 

摘      要：A primary aortoenteric fistula (PAEF), defined as a communication between the native aorta and the gastrointestinal tract, is a rare cause of gastrointes-tinal bleeding. The preoperative diagnosis of PAEF is extremely difficult. Consequently, PAEF may cause sudden and unexpected death. We present an autopsy case of a 68-year-old man who died of massive gastro-intestinal bleeding due to a PAEF. Autopsy revealed a pinhole rupture located on the third part of the duode-nal mucosa and fistulized into the adjacent abdominal aortic aneurysm (AAA). Our case indicates that the aortoenteric fistula can result in fatal gastrointestinal bleeding. Consequently, a PAEF should be included in the differential diagnosis of gastrointestinal bleeding.