Abstract
The objective of this study was to assess early diagnosis and management of hematemesis in patients who have a history of aortic reconstructive surgery. A 70-year-old male presented with complaints of active hematemesis and melena for 2 days at the emergency room. He gave a history of aortobifemoral bypass for bilateral iliac arterial occlusive disease 9 years ago. Urgent computed tomography (CT) angiography was suggestive of large aortic anastomotic pseudoaneurysm with aortoenteric fistula (AEF). Urgent endovascular repair of pseudoaneurysm with right femoral artery to left femoral artery crossover with ligation of left femoral artery, left common iliac artery, and left graft limb was done. The patient did well after the surgical management. Routine follow-up was done. Repeat CT angiography was done. No any major complication was encountered. Secondary AEF is a life-threatening complication of abdominal aortic reconstruction. The clinical manifestation of the AEF is always hematemesis. Treatment of the disease is urgent hybrid surgical intervention.
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