PMC6085234_01
Axial contrast-enhanced computed tomography image of the abdomen showing a large abdominal aortic aneurysm attached to the third part of the duodenum. Air within the wall thrombus of the aneurysm can be seen (arrow).
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AAA with a diameter of 7 cm, which compressed the third part of the duodenum (Fig. 1).
Intraoperative findings of the primary aortoduodenal fistula (PADF). The PADF is located between the posterior wall of the third part of the duodenum and the anterior wall of abdominal aortic aneurysm (arrow).
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Emergent laparotomy revealed dense adhesion between AAA and the third part of the duodenum, which was considered to be PADF (Fig. 2).
Intraoperative gastroduodenal endoscopy findings. Endoscopy shows a pulsating bulge with an adjacent ulcer (arrow) in the third portion of the duodenum.
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Intraoperative gastroduodenal endoscopy revealed an extrinsic pulsatile mass with a central ulceration in the third part of the duodenum (Fig. 3).