Aortoduodenal fistula successfully treated with endovascular repair

Abstract

Aortoduodenal fistula is a rare cause of life‐threatening upper gastrointestinal bleeding. Accurate diagnosis is essential to initiate definitive treatment because endoscopic hemostasis, which is the usual initial intervention for upper gastrointestinal bleeding, may be ineffective. This case underscores timely intervention using endovascular treatment for achieving hemostasis in aortoduodenal fistula.

Aortoduodenal fistula after repair of a stab injury to the abdominal aorta

“…These have included the following: (1) excision of the aortic graft, oversewing of the abdominal aortic stump, axillobifemoral bypass, duodenal repair or resection/anastomosis; (2) excision of the aortic graft, insertion of an in situ antibiotic-impregnated new graft, duodenal repair; (3) injection of a sealant into the fistula, insertion of an endovascular stent graft as a temporizing maneuver in critically ill patients, later replacement of the stent graft and abdominal aorta; and (4) insertion of an endovascular stent graft, lifelong antibiotic therapy in a patient with severe medical comorbidities and a projected limited lifespan. [4][5][6][7][8][9][10][11][12][13]…”