Primary aortoenteric fistula caused by an infected abdominal aortic aneurysm with Mycobacterium Avium Complex in an HIV patient

Primary aortoenteric fistula (PAEF) is a rare but complex clini- cal entity requiring multimodality approach for diagnosis and treatment. We report the first ever case of upper gastrointestinal (UGI) hemorrhage caused by an aortoenteric fistula (AEF) second- ary to mycobacterium avium complex (MAC) in a patient with human immunodeficiency virus (HIV) infection. Esophagogastro- duodenoscopy (EGD) showed an ulcer in the distal duodenum and a computed tomography (CT) scan confirmed a contained abdom- inal aortic aneurysm (AAA) rupture with an aorto-enteric fistula communicating with the third portion of the duodenum. Emergent surgery was undertaken which was lifesaving. A high index of suspicion, early diagnosis and prompt surgical intervention are crucial for survival of patient with PAEF. (Acta gastroenterol. belg., 2010, 73, 280-283).