Aortoenteric Fistula Assocaited with Acute Myocardial Infarcation

A 64-year-old male with a prior abdominal aortic graft for lowerlimb ischemia presented with melena and myocardial infarction. Despite aggressiveinvestigation, an aortoenteric fistula was not diagnosed until after massivegastrointestinal hemorrhage. The patient's myocardial infarction may have heenprecipitated by hypotension induced by hemorrhage through the aortoentericfistula. Patients with prior abdominal aortic graft surgery presenting withgastrointestinal bleeding, abdominal pain or occult sepsis need to be aggressivelyinvestigated to determine whether an aortoenteric fistula is present. Laparotomyshould be done in such patients if no cause for these symptoms can be determined