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Primary aortoenteric fistula (PAEF) is a rare condition of intestinal hemorrhage. We herein report a case of this condition initially suspected by ultrasonographic evaluation and subsequently confirmed by computed tomography. PAEF should be considered a possible cause in patients with gastrointestinal bleeding of uncertain etiology and especially in patients with known aortic aneurysms. The rapid recognition of this condition may save the life of these patients because in untreated subjects the mortality is 100%, frequently due to hypovolemic shock.
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