Tuberculous aorto-duodenal fistula: a rare cause of upper gastrointestinal bleeding.
Chong VH, Telisinghe PU, Chong VH.
Singapore Med J 2010;51(5):e85-e88.
Abstract:
Aorto-enteric fistulas are rare and are associated with significant mortality. Infective causes usually occur within the setting of post-graft repair. Aorto-enteric fistula secondary to tuberculosis is extremely rare despite the high prevalence of this infection. Unfortunately, the diagnosis is often not suspected until surgery or at post-mortem. We report a case of an elderly Malay man presenting with massive gastrointestinal bleeding secondary to a tuberculous aorto-duodenal fistula in association with a saccular abdominal aortic aneurysm. This was successfully managed with an aortobifemoral graft repair and standard anti-tuberculous treatment for six months. A literature review of this rare condition is presented.
Keywords: aneurysm, fistula, gastrointestinal bleeding, tuberculosis
Correspondence: Chong VH, Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Bandar Seri Begawan, BA 1710, Brunei Darussalam, email: chongvuih@yahoo.co.uk.
Article is available free from Singapore Med J on http://smj.sma.org.sg/5105/5105cr2.pdf