• Faizan Nihal, Talha Kareem, Omer Ehsan, Muhammad Iqbal Khan, and Talha Tariq.
• Department of Vascular Surgery, Shifa International Hospital, Islamabad, Pakistan.
• J Coll Physicians Surg Pak. 2023 Jan 1; 33 (1): 656765-67.

AbstractAorto-enteric fistula is a surgical emergency with potentially deadly results. Urgent surgical exploration and repair can lower mortality by 50%. Retroperitoneal fibrosis, mycotic aortic aneurysm, and infectious aortitis can mimic this condition on imaging and lead to unfavourable outcomes. Secondary aorto-enteric fistulas are more common, especially after open aortic repair. Endovascular stent graft repair has a safer profile regarding fistula formation. Ectopic air or contrast extravasation confirms aorto-enteric fistula diagnosis but the latter is not routinely used due to its rarity. Imaging usually shows the bowel adhering to the aneurysm sac with inflammation and ectopic gas. Here, we present a 67-year female with a primary aorto-enteric fistula. She underwent open repair of the abdominal aortic aneurysm using a prosthetic graft and primary anastomosis of the intestine. Key Words: Aorto-enteric fistula, Gastrointestinal bleeding, Aortic aneurysm.

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