Recurrent Aortoenteric Fistula: Case Report and Review

Aortoenteric fistulas (AEFs) are abnormal communications between the aorta and the bowel most frequently resulting from prosthetic graft erosion. Despite advances in surgery and medical technology, these entities are still associated with significant morbidity and mortality for the patient. Multiple case reports and reviews have attempted to elucidate the nature of AEFs in an effort to better characterize and manage these entities. However, reports of recurrence of this process are extremely rare. In this article, we describe a unique case of recurrence of an AEF that was successfully managed with primary aortic oversew and bowel resection. We will also review the literature on AEFs with a comprehensive overview on background, presentation, diagnosis, and current management options.

Introduction

Aortoenteric fistulas are rare and most frequently caused by erosion of prosthetic aortic graft material into the bowel. After operative repair, morbidity and mortality rates remain high. We describe a unique case of a recurrent aortoduodenal fistula in a patient with a history of an infected aortic graft 3 years before presentation who survived her recurrent fistula surgery and was discharged from the hospital in stable condition. The literature on AEFs is reviewed.