, Volume 57, Issue 3, pp 625-629
Date: 22 Oct 2011

Cancer-Associated Aorto-Enteric Fistula

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Case Presentation and Evolution

A 46 year-old woman presented to the emergency department with hematemesis associated with syncope. The patient’s only complaint was severe and diffuse abdominal pain that prohibited her from providing further history. According to her family, she had melena while at home and was found in the bathroom unconscious. The patient spontaneously regained consciousness before arrival of the emergency medical services. She denied any NSAID or aspirin use, although she was on daily enoxaparin for deep vein thrombosis that was extending from her inferior vena cava to her femoral vein. On her arrival at the emergency department, gastroenterology, general surgery, interventional radiology, and intensive care unit teams were consulted about the emergency.

The patient’s prior medical history started with diagnosis with stage IIIC (T3N2M0) sigmoid adenocarcinoma two years previously, in the setting of rectal bleeding. She underwent a left hemi-colectomy, partial cystect