title: Hybrid treatment of a post-EVAR aortoenteric fistula.
abstract: This report presents a case of secondary aortoenteric fistula after endovascular aortic repair in a fragile patient: The fistula developed due to aneurysm shrinkage and remodeling of the stent graft, resulting in a kink eroding through the aneurysm wall into the duodenum. The aortoenteric fistula was successfully treated with a hybrid procedure with endovascular aortic repair, followed by open enteroraphy and omental flap coverage of the stent graft and local antibiotic irrigation. Despite the presence of the stent graft in a previously infected field, the patient has recovered from the acute event with no septic recurrence or hemorrhage during four years of follow-up.
authors.affiliation: Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Sweden karlsorelius@hotmail.com.
authors.forename: Karl
authors.initials: K
authors.lastname: Sörelius
authors.affiliation: Section of Upper Abdominal Surgery, Uppsala University, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Sundbom
authors.affiliation: Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Sweden.
authors.forename: Kevin
authors.initials: K
authors.lastname: Mani
authors.affiliation: Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Wanhainen
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057867:Endoleak / Q000000981:diagnostic imaging / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D015607:Stents; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D018616:Ultrasonography, Doppler, Duplex
keywords: Aortoenteric fistula; anerurysm; endovascular; hybrid; infection