Tabriz University of Medical Sciences Journal of Research in Clinical Medicine 2717-0616 2 4 2014 11 30 Aortoenteric fistula as a rare manifestation of rupture of an abdominal aortic aneurysm: Case report a diagnostic dilemma 217 220 10.5681/jarcm.2014.036 EN Ali Ghavidel Journal Article 10.5681/jarcm.2014.036 2014 06 15 2014 09 14 Introduction: Secondary aortoenteric fistula (SAF) is an uncommon, but very important complication of abdominal aortic reconstruction. The complication often occurs months to years after aortic surgery. The clinical manifestation of the aortoenteric fistula is always upper gastrointestinal bleeding. Treatment of the disease is early surgical intervention. If operative treatment is not performed promptly, the mortality is high. Case Report: A case of secondary aortoduodenal fistula found 6 years after aortic reconstructive surgery, with the clinical presentation of upper gastrointestinal bleeding because of the increasing number of elective aortic aneurysm repairs in the aging population, it is likely that more patients with SAF will present to the clinical physicians in the future. Hence, a high index of suspicion is necessary for prompt diagnosis and treatment of this life-threatening event. The patient treated medically and finally expiration of the patient and review of the literature currently available in Medline. Conclusion: The aim of this case report is to emphasize early diagnosis and management of all gastrointestinal bleeding in patients who have a history of aortic reconstructive surgery.