{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:27:54Z","timestamp":1768433274721,"version":"3.49.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"vor","delay-in-days":335,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Aortoenteric fistula (AEF) is a rare condition and consists of an abnormal communication between the aorta and the gastrointestinal (GI) tract. The duodenum is the most common location. Fistulas involving the stomach are very uncommon and account for only 2% of the cases. AEF typically results in rapid and fatal exsanguination as diagnosis is frequently missed or made too late (Bixby et al., 2018; Kougias et al., 2003; Lookman, 1959; Genc et al., 2000; Ong et al., 2019; Li et al., 2020).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>A 59 years old female with a history of Nissen fundoplication presented with lower gastrointestinal bleeding. Esophagogastroduodenoscopy (EGD) showed a large blood clot in the gastric fundus with no visible source of active bleeding. A mesenteric angiogram, performed for persistent gastro-intestinal bleeding and following two episodes of cardiac arrest, showed no evidence of active bleeding. The left gastric artery was prophylactically embolized. Persistent hemorrhage prompted an exploratory laparotomy followed by a left thoracotomy and confirmed the diagnosis of an aortogastric fistula (AGF). The patient expired intra-operatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>AGF is a very rare but often fatal condition (Busuttil and Goldstone, 2001). Computerized tomography angiography (CTA) can be a key to the diagnosis (Raman et al., 2012). EGD and catheter angiography have low sensitivity (Kuhara et al., 2015; Manduch et al., 2008). Definitive diagnosis is usually made during surgical exploration or autopsy (Wasvary et al., 1997). While open surgical repair is considered the gold standard therapy, endovascular therapy is becoming the preferred initial treatment option (Bixby et al., 2018).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AGF should be considered in the differential diagnosis of GI bleeding, especially in patients with massive hemorrhage where EGD and mesenteric angiography are not diagnostic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.11.154","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T13:23:12Z","timestamp":1607001792000},"page":"890-893","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Primary aortogastric fistula following Nissen fundoplication"],"prefix":"10.1097","volume":"77","author":[{"given":"Abdel Aziz","family":"Jaffan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Larson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil","family":"Kapur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-201-20260114","first-page":"e2386","article-title":"Primary aortoenteric fistula after Nissen fundoplication","volume":"10","author":"Bixby","year":"2018","journal-title":"Cureus"},{"key":"R2-201-20260114","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/153857440303700209","article-title":"Primary aortogastric fistula after Nissen fundoplication: a case report and review of pertinent literature","volume":"37","author":"Kougias","year":"2003","journal-title":"Vasc. Endovasc. Surg"},{"key":"R3-201-20260114","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1002\/bjs.18004620026","article-title":"Aortogastric fistula","volume":"46","author":"Lookman","year":"1959","journal-title":"Br. J. Surg"},{"key":"R4-201-20260114","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1053\/ejvs.1999.1085","article-title":"Primary aortogastric fistula","volume":"19","author":"Genc","year":"2000","journal-title":"Eur. J. Vasc. Endovasc. Surg"},{"key":"R5-201-20260114","doi-asserted-by":"crossref","first-page":"e72","DOI":"10.1016\/j.cgh.2019.03.033","article-title":"Aortogastric fistula: a rare glimpse of catastrophe","volume":"18","author":"Ong","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol"},{"key":"R6-201-20260114","doi-asserted-by":"crossref","first-page":"e169","DOI":"10.1016\/j.jemermed.2020.01.010","article-title":"Primary aortogastric fistula caused by ulcerated gastric carcinoma: a rare cause of sudden death","volume":"58","author":"Li","year":"2020","journal-title":"J. Emerg. Med"},{"key":"R7-201-20260114","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1053\/svas.2001.27888","article-title":"Diagnosis and management of aortoenteric fistulas","volume":"14","author":"Busuttil","year":"2001","journal-title":"Semin. Vasc. Surg"},{"key":"R9-201-20260114","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1177\/014107680710000514","article-title":"Aortogastric fistula secondary to pancreatitis","volume":"100","author":"Ardolino","year":"2007","journal-title":"J. R. Soc. Med"},{"key":"R10-201-20260114","doi-asserted-by":"crossref","first-page":"1659.e21","DOI":"10.1016\/j.avsg.2015.06.080","article-title":"Aortogastric fistula due to a penetrating atherosclerotic aortic ulcer","volume":"29","author":"Dalio","year":"2015","journal-title":"Ann. Vasc. Surg"},{"key":"R11-201-20260114","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/00000658-198203000-00011","article-title":"Aortoenteric fistula: incidence, presentation, recognition, and management","volume":"195","author":"Champion","year":"1982","journal-title":"Ann. Surg"},{"key":"R12-201-20260114","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1155\/2008\/784132","article-title":"Fatal hemorrhage from a gastroaortic fistula secondary to gastric ulceration associated with Nissen fundoplication and nonsteroidal anti-inflammatory drug use","volume":"22","author":"Manduch","year":"2008","journal-title":"Can. J. Gastroenterol"},{"key":"R13-201-20260114","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1111\/j.1445-2197.1990.tb07482.x","article-title":"Aorto-gastric fistula following Nissen fundoplication","volume":"60","author":"Agrez","year":"1990","journal-title":"Aust. N. Z. J. Surg"},{"key":"R14-201-20260114","first-page":"300","article-title":"Gastro aortic fistula: complication following Thal patch and Nissen fundoplication","volume":"77","author":"Harwood","year":"1980","journal-title":"Colo. Med"},{"key":"R15-201-20260114","first-page":"455","article-title":"Gastro-aortic fistula: an uncommon complication of Nissen fundoplication","volume":"63","author":"Wasvary","year":"1997","journal-title":"Am. Surg"},{"key":"R16-201-20260114","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/j.1572-0241.2000.01719.x","article-title":"Acute gastrointestinal bleeding hemorrhage from an ulcer on a Nissen fundoplication","volume":"95","author":"Pianka","year":"2000","journal-title":"Am. J. Gastroeterol"},{"key":"R17-201-20260114","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1007\/s00261-006-9062-7","article-title":"Aortoenteric fistula: a diagnostic dilemma","volume":"32","author":"Hughes","year":"2007","journal-title":"Abdom. Imaging"},{"key":"R18-201-20260114","first-page":"458","article-title":"Aorto-enteric fistulae: an uncommon complication of abdominal aortic aneurysms","volume":"59","author":"Reckless","year":"1972","journal-title":"Br. J. Med. Surg. Urol"},{"key":"R19-201-20260114","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.jss.2018.04.020","article-title":"Analysis of risk factors and classification of aortic fistula after esophagectomy","volume":"229","author":"Cheng","year":"2017","journal-title":"J. Surg. Res"},{"key":"R20-201-20260114","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.ejvs.2011.02.020","article-title":"Early and late results of contemporary management of 37 secondary aortoenteric fistulae","volume":"41","author":"Batt","year":"2011","journal-title":"Eur. J. Vasc. Endovasc. Surg"},{"key":"R21-201-20260114","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.diii.2012.07.003","article-title":"Aortoa-enteric fistulas: a physopathological approach and computed tomography diagnosis","volume":"93","author":"Mathia","year":"2012","journal-title":"Diagn. Interv. Imaging"},{"key":"R22-201-20260114","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s00261-012-9873-7","article-title":"Aorto-entreic fistulas: spectrum of CT findings","volume":"38","author":"Raman","year":"2013","journal-title":"Abdom. Imaging"},{"key":"R23-201-20260114","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.jvir.2007.02.009","article-title":"Diagnosis of aortoenteric fistulas with CT angiography","volume":"18","author":"Hagspiel","year":"2007","journal-title":"J. Vasc. Interv. Radiol"},{"key":"R24-201-20260114","doi-asserted-by":"crossref","first-page":"386.e1","DOI":"10.1016\/j.avsg.2010.09.021","article-title":"Primary aortoaenteric fistulae: the challenges in diagnosis and review of treatment","volume":"25","author":"Ranasinghe","year":"2011","journal-title":"Ann. Vasc. Surg"},{"key":"R25-201-20260114","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1016\/j.jvs.2004.08.044","article-title":"Combined endovascular stent grafting and endoscopic injection of fibrin sealant for aortoenteric fistula complicating esophagectomy","volume":"40","author":"Mok","year":"2004","journal-title":"J. Vasc. Surg"},{"key":"R26-201-20260114","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.jvs.2008.08.068","article-title":"Outcome after endovascular stent graft repair of aortoenteric fistula: a systematic review","volume":"49","author":"Antoniou","year":"2009","journal-title":"J. Vasc. Surg"},{"key":"R27-201-20260114","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.ejvs.2010.12.026","article-title":"Open or Endovascular Repair of Aortoenteric fistulas? A multicentre Comparative study","volume":"41","author":"Kakkos","year":"2011","journal-title":"Eur. J. Vasc. Endovasc. Surg"},{"key":"R28-201-20260114","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ijsu.2018.10.028","article-title":"The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines","volume":"60","author":"Agha","year":"2018","journal-title":"Int. J. Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220311834?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220311834?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.11.154","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:13:27Z","timestamp":1768396407000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.11.154"}},"subtitle":["A case report"],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":27,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2020.11.154","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}