A 70-year-old man presents to the emergency department with a history of a single episode of massive hematemesis and melena. Past history includes coronary artery disease, hypertension and abdominal aortic aneurysm repair. He is on one 75mg aspirin daily. Upper G.I. endoscopy revealed blood emerging distal to 2nd part of duodenum. What is the most likely diagnosis?
سؤال مجاني 3 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
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الإجابة: C. Aorto-enteric fistula
Massive hematemesis + melena in a patient with a previous AAA repair (aortic graft), with blood coming from beyond the 2nd part of the duodenum, means an aorto-enteric fistula. This is a fistula between the aorta and the 3rd/4th part of the duodenum. Meckel's and AVMs do not explain the graft history or the site, and lymphoma rarely bleeds massively.
- المصدر
- 14• GI Bleed [Notes].pdf · p. 1
10• Aortic Diseases [Notes].pdf · p. 6 - المحاضرة
- GI bleeding · General Surgery · Module D
- ظهر في
- Surgery QB (Module D) p. 102 Q26