Abstract
Aortoenteric fistula is an uncommon but life-threatening cause of gastrointestinal blood loss. We report a case of a 70-year-old man who presented to the emergency department with an episode of melena and infection in the left inguinal region. Diagnosis of secondary aortoenteric fistula was made between the left limb of the aortobifemoral graft and the descending colon. We performed excision of the infected graft and in situ silver acetate coating of prosthetic vascular graft replacement (aortoleft femoral) on the patient. This study reports a rare type of secondary aortoenteric fistula to the left colon, and it describes an unusual and successful surgical treatment. Antimicrobial coating of prosthetic vascular grafts may be a good alternative in the presence of graft infection associated with aortoenteric fistula because in situ grafts may carry an increased risk of reinfection.
Highlights
Aortoenteric fistula (AEF) is a rare and life-threatening condition associated with diagnostic challenges
Secondary aortoenteric fistulae occur as a result of iatrogenic causes, mostly as a complication of aortic interventions
A rare case of aortoenteric fistula developing between the distal part of the left limb of the aortobifemoral graft and the colon is described
Summary
Aortoenteric fistula (AEF) is a rare and life-threatening condition associated with diagnostic challenges. Primary aortoenteric fistula occurs when an erosive aortic segment opens into the adjacent gastrointestinal lumen. This commonly occurs in abdominal aortic aneurysms. Secondary aortoenteric fistula is a complication of aortic reconstructive surgery involving the use of vascular grafts, and it is located between the graft and the adjacent segment of the intestines [1,2,3]. Aortocolonic fistulae are much less frequent, representing 5 to 6% of the cases [5] In this case report, a very rare form of secondary AEF, an aortocolonic fistula formation, is presented along with a discussion regarding the surgical technique applied
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