Aortoenteric Fistula Causing Syncope and Gastrointestinal Bleeding

Aortoenteric fistula (AEF) is an uncommon and emergency clinical condition of intra-abdominal bleeding. Early diagnosis can be achieved by computed tomography and endoscopy exploration. Surgical reconstruction is an urgent and multidisciplinary treatment and is recommended after the surgical intervention. A 76-year-old man with a history of abdominal aortic aneurysm reconstruction presented to the emergency department with syncope and suspected upper gastrointestinal (GI) bleeding, which began approximately 30 min before. In the hospital, the patient's condition worsened and he developed cardiac arrest due to massive GI bleeding. The advanced cardiopulmonary resuscitation was initiated and with suspected active aortoenteric communication, an urgent laparoscopy was immediately performed.