-To identify the radiographic features of aortoenteric fistulas on computed tomography (CT) -To review the differential diagnosis between aortoenteric fistulas and aortic prosthetic infections without fistulization.

An aortoenteric fistula (AEF) is a communication between the aorta and the gastrointestinal tract. Gastrointestinal bleeding is the most common clinical presentation, which can be minor in early phases followed by a massive hemorrhage in later phases. Other symptoms that may be present include sepsis and abdominal pain. It is a rare entity with a nonspecific clinical presentation that requires a high index of suspicion for diagnosis and a mortality rate as high as 86% if left untreated. Early diagnosis and management is essential for...

Diagnostic techniques Due to its widespread availability and short acquisition time CT is the imaging modality of choice, despite having a variable sensitivity (40-90%) and specificity (33-10%). The CT protocol in our institution consists of non-contrast CT followed by contrast enhanced study on arterial, venous and delayed phases. The non-contrast study is used for detection of hyperattenuating blood content within the intestinal lumen. The arterial and venous phases are used for vascular assessment and for the detection of the site of active contrast extravasation. The...

AEF is a life threatening condition which requires prompt diagnosis and a high index of clinical suspicion. It should be considered in patients presenting gastrointestinal bleeding and a history of aortic reconstructive surgery. The differential diagnosis with aortic graft infection without fistulization is difficult based on imaging techniques only. Contrast extravasation to the bowel lumen is a pathognomonic sing of AEF but may not be proven. The demonstration of perigraft gas in a clinical context of gastrointestinal bleeding is highly suggestive of AEF.

J. Badiola Molinuevo; Donostia - San Sebastián/ES - nothing to disclose J. Burgos Ruiz; Donostia - San Sebastián/ES - nothing to disclose A. Luis Fernández; Donostia - San Sebastián/ES - nothing to disclose A. Serdio; Donostia - San Sebastián/ES - nothing to disclose M. Gredilla; Donostia - San Sebastián/ES - nothing to disclose K. Biurrun Mancisidor; Donostia - San Sebastián/ES - nothing to disclose

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