Aortoduodenal Fistula After Endovascular Aortic Repair for an Inflammatory Abdominal Aortic Aneurysm: A Case Report

Abstract

Aortoenteric fistula after endovascular aortic repair for an abdominal aortic aneurysm is a rare but severe complication. Particularly, a case of inflammatory abdominal aortic aneurysm is extremely rare and there are only 3 reported cases. A 70-year-old man underwent endovascular aortic repair for impending rupture of an inflammatory abdominal aortic aneurysm and was medicated steroids for approximately 2 years. Four years after endovascular aortic repair, he developed endograft infection with an aortoduodenal fistula and a left psoas abscess. He underwent total endograft excision, debridement, in situ reconstruction of the aorta using prosthetic grafts with omental coverage, and digestive tract reconstruction to prevent leakage. Pseudomonas aeruginosa was detected in the infected aortic sac. The patient has not experienced recurrence of infection in the 35 months since his operation.

Aortoenteric fistula in a man with history of endovascular aneurysm repair that presented with abdominal pain and anaemia

“…These findings were highly suggestive of aortoenteric fistula (AEF) after EVAR. 2 , 3 Contrast-enhanced CT considers the first imaging modality in cases who are suspected of AEF, characterized by the presence of gas around the stent graft within the aortic aneurysm sac. 4 Besides, evidence of inflammation, including fat stranding, periaortic oedema, and periaortic fluid, was observed surrounding the aortic aneurysm in CT imaging.…”

Echocardiography and FDG-PET/CT scan in Gram-negative bacteremia and cardiovascular infections

“…There are no well-performed population-based studies systematically evaluating the risk of cardiovascular infections in cohorts of all-comers GNB non-HACEK BSIs. Instead most reports have focused on describing interesting clinical cases of GNB non-HACEK IE and VGI [6][7][8][9]. In addition, several studies have described how big a proportion of cardiovascular infections that are caused by GNB non-HACEK (Table 1a).…”