PMC2822317_01
Preoperative contrast-enhanced axial computed tomography demonstrates a 9.5-cm wide abdominal aortic aneurysm (A) tightly attached to the duodenum (D).
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F1
Upper gastrointestinal endoscopy and computed tomography were performed at an outside facility, which showed a huge pulsating submucosal mass-like lesion with mucosal hemorrhage on the third duodenal portion and an infrarenal aortic aneurysm suspicious of duodenal erosion (Fig. 1).
The gross pathology of the resected aortoduodenal specimen shows ruptured abdominal aortic aneurysm (A) with a thrombus encroaching the duodenal wall (D). Note the absence of a muscle layer and serosa in the duodenal wall.
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F2
The fistula-bearing area of the aneurysm was resected en bloc with the attached duodenum (Fig. 2).