Endovascular treatment of a bleeding secondary aortoenteric fistula in a high-risk patient☆
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Fig. 1
Preoperative esophagogastroduodenoscopy showing AEF in the duodenum with no evidence of bleeding.
Fig. 2
Coronal computed tomographic angiography demonstrating an intact tubular surgical graft, without perigraft air, contrast extravasation, pseudoaneurysm, or fluid collection. It depicts the length of the right aortoiliac tube graft and the distance from the left renal artery to the AEF. Ascites is present.
Fig. 3
A, Axial image depicts the close contact between the graft and the duodenum, which has no posterior wall. B, Coronal image demonstrating the same.
Fig. 4
A, Postdeployment angiogram confirming exclusion of the fistula. B, Aortouniiliac graft.
Abstract
We report a patient with life-threatening gastrointestinal bleeding caused by a secondary aortoenteric fistula (AEF). Because the patient had severe medical comorbidities, an endovascular approach was chosen for hemorrhage control. Endovascular treatment of aortoenteric fistula provides another treatment option that may be particularly valuable in patients whose comorbidities would preclude open repair.
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☆The authors have no financial or other conflicts of interest related to the submission.
