case_images: PMC11176620_01
case_images: Three dimensional reconstructions of the evolution of the double aorto-enteric fistula (AEF). (A) A reconstruction of the aorta six months prior to the primary aorto-enteric fistula. (B) Imaging taken at the clinical presentation of the primary AEF; the scan shows a clear saccular aneurysm with extravasation to the duodenum (arrow). (C) Pseudoaneurysm (arrow) on the latest computed tomography scan available two weeks pre-operatively for the secondary AEF (focused on the latter secondary AEF).
case_images: gr1.jpg
case_images: PMC11176620_01_gr1.jpg
case_images: fig1
case_images: In March 2020, full body computed tomography (CT) imaging was performed to determine the leukaemia stage, without findings of aortic pathology (Fig. 1A). As melaena and hypotension persisted, CT angiography was performed and a 6.1 cm diameter infrarenal saccular aortic aneurysm with suspected AEF was diagnosed (Figure 1, Figure 2, arrows) and the patient underwent an emergency operation. Retrospectively, the presence of recurrent AEF might have been suspected due to contact between the duodenum and pseudoaneurysm (Fig. 1C, Fig. 3, arrows).
case_images: Multiple planar reconstruction of a computed tomography scan showing a large aortic aneurysm and primary aorto-enteric fistula (arrow).
case_images: gr2.jpg
case_images: PMC11176620_01_gr2.jpg
case_images: fig2
case_images: As melaena and hypotension persisted, CT angiography was performed and a 6.1 cm diameter infrarenal saccular aortic aneurysm with suspected AEF was diagnosed (Figure 1, Figure 2, arrows) and the patient underwent an emergency operation.