Aortoenteric fistulas: CT features and potential mimics

Quan D.M. Vu, Christine O. Menias, Sanjeev Bhalla, Christine Peterson, Lisa Lihaun Wang, Dennis M. Balfe

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Prompt diagnosis of aortoenteric fistulas is imperative for patient survival. The clinical signs of aortoenteric fistula include hematemesis, melena, sepsis, and abdominal pain, but the condition also may be clinically occult. Because clinical signs may not be present or may not be sufficiently specific, imaging is most often necessary to achieve an accurate diagnosis. Although no single imaging modality demonstrates the condition with sufficient sensitivity and specificity, computed tomography (CT), owing to its widespread availability and high efficiency, has become the imaging modality of choice for evaluations in the emergency setting. CT has widely variable sensitivity (40%-90%) and specificity (33%-100%) for the diagnosis of aortoenteric fistulas. To use this modality effectively for the initial diagnostic examination, radiologists must be familiar with the spectrum of CT appearances. Mimics of aortoenteric fistulas include retroperitoneal fibrosis, infected aortic aneurysm, infectious aortitis, and perigraft infection without fistulization. Differentiation is aided by the observation of ectopic gas, loss of the normal fat plane, extravasation of aortic contrast material into the enteric lumen, or leakage of enteric contrast material into the paraprosthetic space; these features are highly suggestive of aortoenteric fistula in a patient with bleeding in the gastrointestinal tract.

Original languageEnglish (US)
Pages (from-to)197-209
Number of pages13
JournalRadiographics
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2009

Fingerprint

Fistula
Tomography
Contrast Media
Aortitis
Retroperitoneal Fibrosis
Infected Aneurysm
Melena
Hematemesis
Aortic Aneurysm
Abdominal Pain
Gastrointestinal Tract
Sepsis
Emergencies
Gases
Fats
Observation
Hemorrhage
Sensitivity and Specificity
Survival
Infection

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Vu, Q. D. M., Menias, C. O., Bhalla, S., Peterson, C., Wang, L. L., & Balfe, D. M. (2009). Aortoenteric fistulas: CT features and potential mimics. Radiographics, 29(1), 197-209. https://doi.org/10.1148/rg.291075185
Vu, Quan D.M. ; Menias, Christine O. ; Bhalla, Sanjeev ; Peterson, Christine ; Wang, Lisa Lihaun ; Balfe, Dennis M. / Aortoenteric fistulas : CT features and potential mimics. In: Radiographics. 2009 ; Vol. 29, No. 1. pp. 197-209.
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Vu, QDM, Menias, CO, Bhalla, S, Peterson, C, Wang, LL & Balfe, DM 2009, 'Aortoenteric fistulas: CT features and potential mimics', Radiographics, vol. 29, no. 1, pp. 197-209. https://doi.org/10.1148/rg.291075185

Aortoenteric fistulas : CT features and potential mimics. / Vu, Quan D.M.; Menias, Christine O.; Bhalla, Sanjeev; Peterson, Christine; Wang, Lisa Lihaun; Balfe, Dennis M.

In: Radiographics, Vol. 29, No. 1, 01.01.2009, p. 197-209.

Research output: Contribution to journalArticle

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Vu QDM, Menias CO, Bhalla S, Peterson C, Wang LL, Balfe DM. Aortoenteric fistulas: CT features and potential mimics. Radiographics. 2009 Jan 1;29(1):197-209. https://doi.org/10.1148/rg.291075185