A Case of Aortoenteric Fistula Following Abdominal Aortic Reconstruction

Koji Tsutsumi, MD,PhD,1 Yoshinobu Sato, MD,2 and Mikihiko Ookura, MD1

We report the case of a 64-year-old male patient with graft-enteric fistula. This complication might have been induced by sigmoid colonic ischemia resulting from injury to the mesocolon during abdominal aortic reconstruction. Although sigmoid colonic exteriorization was performed to avoid simultaneous colonic resection, graft-enteric fistula could not be prevented. Two further emergent operations were required to obtain complete remission from this complication, comprising bilateral extra-anatomical axillofemoral bypass grafts and infected graft removal, followed by an operation for left common iliac artery stump disruption. Although the patient remained in good health for 3 years with no complications, he died of aortic stump disruption 43 months after the last operation. (Ann Thorac Cardiovasc Surg 2007; 13: 282-286)

Key words: graft-enteric fistula, colonic exteriorization, extra-anatomical axillofemoral bypass grafts

1Division of Cardiovascular Surgery and 2Department of Surgery, Sagamihara Kyodo Hospital, Sagamihara, Japan

Received May 15, 2006; accepted for publication December 8, 2006
Address reprint requests to Koji Tsutsumi, MD, PhD: Division of Cardiovascular Surgery, Ashikaga Red Cross Hospital, 3–2100 Honjo, Ashikaga 326–0808, Japan.