[Skip to Content]
[Skip to Content Landing]
June 7, 1976

Aortoduodenal Fistula Secondary to Metastatic Carcinoma: Angiographic Demonstration

Author Affiliations

From the Department of Diagnostic Radiology (Dr Geary) and the Department of Surgery (Dr Walworth), Dartmouth-Hitchcock Medical Center, Hanover, NH. Dr Geary is now with the Department of Radiology, Addison Gilbert Hospital, Gloucester, Mass.

JAMA. 1976;235(23):2520-2521. doi:10.1001/jama.1976.03260490038019

AORTODUODENAL fistula is an uncommon but well-recognized pathologic entity. The majority of cases are caused by rupture of an aortic aneurysm or are complications of aortic reconstructive surgery. Carcinoma, either primary or metastatic, is a distinctly unusual cause. Because of the lesion's infrequency and its accompanying grave clinical condition, few patients with gastrointestinal hemorrhage caused by aortoduodenal fistula have been studied angiographically. The following is a case in which the fistula and its cause were detected by angiography.

Report of a Case  A 36-year-old woman had an exophytic lesion of the uterine cervix in September 1971. Results of a physical examination were otherwise normal. Hemogram, liver chemistry values, chest x-ray film, intravenous urogram, barium enema examination, sigmoidoscopy, and cystoscopy were normal. A biopsy specimen showed invasive, well-differentiated carcinoma, representing stage IB tumor.The patient received 4,000 rads of external radiation to the pelvis, followed by brief readmissions for intracavitary radiation