Primary aorto-enteric fistula – a unique complication of poorly differentiated large B-cell lymphoma

Patient: Male, 76 Final Diagnosis: Aorto-enteric fistula Symptoms: Abdominal pain • bloody vomiting • shock Medication: — Clinical Procedure: CT abdomen with contrast Specialty: Gastroenterology • vascular surgery OBJECTIVE: Rare disease BACKGROUND: Primary Aorto-Enteric Fistula (PAEF) is a unique and rare life threatening communication between the Aorta and Gastrointestinal Tract with an unusually high mortality rate and delayed diagnosis. Aortic abdominal aneurysms are implicated in a vast majority of cases while cancer as an etiology of PAEF is extremely rare. CASE REPORT: We present the first case report of a PAEF secondary to Large B-Cell Lymphoma, followed by a review of literature in regards to malignant aorto-enteric fistulae. CONCLUSIONS: We conclude that physicians should maintain a high index of suspicion for PAEF in any patient with unexplained anemia and history of aortic abdominal aneurysm complicated by cancer.