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Case Reports
. 2016 Jul;41(4):350-3.

An Aortoenteric Fistula Arising after Endovascular Management of a Mycotic Abdominal Aortic Aneurysm Complicated with a Psoas Abscess

Aytaç Gülcü  1 , Naciye Sinem Gezer  1 , Şevket Baran Uğurlu  2 , Ahmet Yiğit Göktay  1
Affiliations
Case Reports

An Aortoenteric Fistula Arising after Endovascular Management of a Mycotic Abdominal Aortic Aneurysm Complicated with a Psoas Abscess

Aytaç Gülcü et al. Iran J Med Sci. 2016 Jul.

Abstract

Mycotic aortic aneurysms account for 1-3% of all aortic aneurysms. The management of this disease is controversial. Since open surgical repair is associated with high morbidity and mortality rates, endovascular aneurysm repair is an alternative treatment method with promising early and midterm outcomes, although its long-term durability is unknown. Secondary aortoenteric fistulas may occur iatrogenically after either aortic reconstructive surgery or endovascular repair. As the number of aneurysms managed with endovascular aneurysm repair has substantially increased, cases of aortoenteric fistulas referred for endovascular repair are augmented. We report the case of an aortoduodenal fistula manifested with duodenal perforation after staged endovascular and surgical treatment of a mycotic aortic aneurysm.

Keywords: Aortic aneurysm; Endovascular aortic repair; Fistula; Infection.

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Figures

Figure 1
Figure 1
(A) Axial computed tomography angiography image of the irregularly shaped, saccular mycotic infrarenal abdominal aortic aneurysm (red arrows) and the left-sided psoas abscess (white arrows) is presented here. (B) Three- dimensional view of the mycotic aortic aneurysm is depicted.
Figure 2
Figure 2
Sagittal reformat contrast-enhanced computed tomography images show the growing aneurysm sac by type 1B endoleak and the expanding tubular stent graft at the distal end due to the growing aneurysm.
Figure 3
Figure 3
Multiplanar reformat images of the aortoenteric fistula (red arrows) with negative oral contrast media.
See this image and copyright information in PMC

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