RT Journal Article SR Electronic T1 Primary aortoduodenal fistula without abdominal aortic aneurysm JF Cleveland Clinic Journal of Medicine JO Cleve Clin J Med FD Cleveland Clinic SP 579 OP 581 VO 52 IS 4 A1 Mark T. Jaroch A1 James T . Diehl A1 Albert M. Zippert YR 1985 UL http://www.ccjm.org/content/52/4/579.abstract AB Primary aortoduodenal fistula is an uncommon entity usually associated with untreated abdominal aortic aneurysms. The third reported case of primary aortoduodenal fistula without an aneurysm is presented. The diagnosis of primary aortoduodenal fistula is often difficult to make because conventional studies, such as an upper gastrointestinal series or aortography, have not been reliable. Fiberoptic upper gastrointestinal endoscopy to the fourth portion of the duodenum has been diagnostic in 58% of secondary aortoduodenal fistulas, and this technique may be used for the diagnosis of primary aortoduodenal fistulas. Definitive operative therapy consists of repairing the duodenal fistula and aortic resection with tube graft replacement or extra-anatomic reconstruction. A review of the experience with primary aortoduodenal fistulas from the current literature is presented.