Secondary aortoenteric fistula successfully treated with staged endovascular repair and duodenal resection without graft removal

Abstract

Secondary aorto-enteric fistulae (SAEF) are rare life-threatening complications that occur after abdominal aortic graft implant to treat aortic aneurysm or occlusive disease. Conventional treatments such as extra-anatomic bypass grafting with aortic ligation and subsequent graft removal with bowel repair are associated with a 25% to 90% operative mortality rate. In the emergency setting, patients unsuitable for major arterial surgery may benefit from a staged, less invasive approach. We present a case of SAEF treated with endoluminal deployment of a stent graft followed by duodenojejunal resection and anastomosis without further aortic reconstruction and graft removal.

Keywords:

• Duodenal resection
• endovascular repair
• endovascular stent graft
• high-risk patients
• secondary aortoenteric fistula

Declaration of interest

No potential conflict of interest was reported by the authors.