Primary aortoduodenal fistula following radiotherapy.

Primary aortoduodenal fistula is a rare condition. Common causes include atherosclerosis, leading to formation of an aortic aneurysm (most common); syphilis; carcinoma of the pancreas; trauma; tuberculosis, and myocosis. Presented herein is the recognition and successful treatment of what appears to be the first patient with a primary aortoduodenal fistula following paraaortic radiotherapy. Once suspected, immediate surgical treatment is mandatory. Primary aortic control (closure or resection), along with resection of the diseased intestinal segment, would appear to be the safest and most acceptable treatment.