title: Primary aortoenteric fistula following endovascular aortic repair due to type II endoleak.
abstract: An 84-year-old female was lost to follow-up after endovascular aneurysm repair at another hospital with known type II endoleak. She later presented with presyncope and hematemesis. A referral center esophagogastroduodenoscopy showed possible duodenal diverticulum. She had recurrent symptoms and repeat computed tomography scan showed air within the aortic sac. At our center, she underwent stent graft explantation and axillofemoral reconstruction for a primary aortoenteric fistula. She was discharged and is doing well 5 months postoperatively. A high degree of suspicion for aortoenteric fistula is imperative in any patient with upper gastrointestinal hemorrhage after open or endovascular abdominal aortic aneurysm repair.
authors: Division of Vascular and Endovascular Surgery, Brigham and Women’s Hospital, 75 Francis St., Boston, Mass 2115, USA. jtmcphee@partners.org
authors: James T
authors: JT
authors: McPhee
authors: David I
authors: DI
authors: Soybel
authors: Robert K
authors: RK
authors: Oram
authors: Michael
authors: M
authors: Belkin
mesh_terms: D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001018:Aortic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D020878:Device Removal; D057867:Endoleak / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016145:Endoscopy, Digestive System; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery