Ann Geriatr Med Res 2018; 22(1): 40-42  http://dx.doi.org/10.4235/agmr.2018.22.1.40
Asymptomatic Secondary Aortoduodenal Fistula Incidentally Diagnosed During a Health Check-up: A Case Report
Sang Ki Park1, In Chul Min2, Sung Hoon Lee1, Jae Ik Lee1, Ji Min Kim3, Kyong Hye Joung3, Bon Jeong Ku3
Departments of 1Internal Medicine and 2General Surgery, City Clinic, Daejeon, 3Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
Correspondence to: Bon Jeong Ku, MD, PhD
Department of Internal Medicine, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea
Tel: +82-42-280-7149
Fax:+82-42-280-6990
E-mail: bonjeong@cnu.ac.kr
Received: January 23, 2018; Revised: January 23, 2018; Accepted: February 20, 2018; Published online: March 31, 2018.
© The Korea Geriatrics Society. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Secondary aortoenteric fistulas (AEFs) are an uncommon but fatal complication of abdominal aortic reconstructive surgery. Aortoduodenal fistulas (ADFs) are the most frequent secondary AEFs (80%). The incidence of secondary AEFs is increasing because of the increasing number of individuals undergoing aortic aneurysm repairs with prosthetics. In most cases of secondary AEFs, surgical repair is performed with the patient in a poor condition, owing to late diagnosis. Thus, an early diagnosis is crucial. We report a case of an asymptomatic secondary ADF that was incidentally diagnosed using esophagogastroduodenoscopy (EGD) and computed tomography during a health check-up and was successfully repaired, with the patient in a stable condition even after the development of life-threatening symptoms. Based on our case, we suggest that noticing unexplained leukocytosis in regular hematological examination and performing surveillance EGD in an asymptomatic individual who has undergone abdominal aortic reconstructive surgery may aid in the early diagnosis of secondary AEFs before fatal complications manifest.
Keywords: Aorta, Duodenum, Fistula, Asymptomatic Disease


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