Abdominal and GI imaging: secondary aortoenteric fistula: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Abdominal and GI imaging: secondary aortoenteric fistula

Sample item

A man who had an open aortic graft three years ago has a small haematemesis followed by fever. CT shows gas bubbles and soft tissue surrounding the graft next to the third part of the duodenum. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Secondary aortoenteric fistula

A secondary aortoenteric fistula forms between a previous aortic graft and the duodenum, giving a herald bleed and graft infection. CT shows perigraft gas and soft tissue. A perforated ulcer gives free intraperitoneal air, and a pseudocyst or retroperitoneal fibrosis does not produce graft gas.

Option by option

  • A. Retroperitoneal fibrosis

    Retroperitoneal fibrosis forms a plaque around the aorta without gas or bleeding.

  • B. Secondary aortoenteric fistula (correct)

    Correct. Perigraft gas next to the duodenum with a herald bleed is a graft-enteric fistula.

  • C. Pancreatic pseudocyst

    A pseudocyst is a fluid collection after pancreatitis and does not contain graft gas.

  • D. Perforated peptic ulcer

    A perforated ulcer gives free air under the diaphragm rather than perigraft gas.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Secondary aortoenteric fistula. A secondary aortoenteric fistula forms between a previous aortic graft and the duodenum, giving a herald bleed and graft infection.

Why is "Retroperitoneal fibrosis" not the answer?

Retroperitoneal fibrosis forms a plaque around the aorta without gas or bleeding.

Why is "Pancreatic pseudocyst" not the answer?

A pseudocyst is a fluid collection after pancreatitis and does not contain graft gas.

Why is "Perforated peptic ulcer" not the answer?

A perforated ulcer gives free air under the diaphragm rather than perigraft gas.

What concept does this question test?

It tests Abdominal and GI imaging: secondary aortoenteric fistula in Radiology. CT shows perigraft gas and soft tissue. A perforated ulcer gives free intraperitoneal air, and a pseudocyst or retroperitoneal fibrosis does not produce graft gas.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdominal and GI imaging: secondary aortoenteric fistula?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.