[Digestive hemorrhage as the first symptom of a rupture of an abdominal aortic aneurysm].

Primary aortoduodenal fistula is an uncommon complication of abdominal aortic aneurysm and is a rare cause of gastrointestinal bleeding. A case of primary arterioenteric fistula due to the rupture of an abdominal aortic aneurysm into the third portion of the duodenum is presented. Aneurysmectomy, duodenal repair, and extra-anatomic revascularization of the legs was performed. Diagnosis of primary aortoenteric fistula is difficult. The usual explorations are not demonstrative, and exploratory laparotomy is often mandatory.