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Ann Geriatr Med Res > Volume 22(1); 2018 > Article
Annals of Geriatric Medicine and Research 2018;22(1):40-42.
DOI: https://doi.org/10.4235/agmr.2018.22.1.40    Published online March 31, 2018.
Asymptomatic Secondary Aortoduodenal Fistula Incidentally Diagnosed During a Health Check-up: A Case Report
Sang Ki Park, In Chul Min, Sung Hoon Lee, Jae Ik Lee, Ji Min Kim, Kyong Hye Joung, Bon Jeong Ku
1Department of Internal Medicine, City Clinic, Daejeon, Korea.
2Department of General Surgery, City Clinic, Daejeon, Korea.
3Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. bonjeong@cnu.ac.kr
Correspondence:  Bon Jeong Ku, Tel: +82-42-280-7149, Fax: +82-42-280-6990, 
Email: bonjeong@cnu.ac.kr
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.
Key Words: Aorta, Duodenum, Fistula, Asymptomatic Disease
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