Primary aortoappendiceal fistula: case report and review of the literature.

We report a case of primary aortoappendiceal fistula in a patient with chronic, relapsing abdominal symptoms and acute lower gastrointestinal hemorrhage. The diagnosis was evident with abdominal computed tomographic scan results. The patient's condition was successfully managed with appendectomy, abdominal aortic aneurysm resection, and extra-anatomic bypass grafting. Review of the literature revealed this to be the first report of a true aortoappendiceal fistula.