Aortoenteric fistula: a possible cause of sudden death. Case report

An aortoenteric fistula is an open link between the aorta and a portion of the gastrointestinal tract. Aortoenteric fistulas (AEFs) are rare clinical entities that result in fatal exsanguination if undiagnosed. They are in the majority of cases the result of erosion of the bowel wall, caused by abdominal aortic aneurysm, and mostly involve the third portion of the duodenum. Most cases of AEF occur in middle-aged or elderly patients. We report the case of 83-year-old woman, who had suffered a surgical intervention for a gastric ulcer, and died 3 days later, in the hospital. At the autopsy we discovered an aortoduodenal communication due to a penetrating atherosclerotic ulcer into the duodenum. This resulted into acute enteral hemorrhage with consequent death.