Late-term complication of endograft repair for aortoenteric fistula

Aortoenteric fistula is a devastating complication of aortic aneurysm repair. Traditional repair carries a high risk of mortality and significant morbidity. While endograft repair can be effective at mitigating the immediate life-threatening bleed, the temptation to consider endograft repair as definitive treatment should be resisted. We present a case of a 72 year old male who developed an aortoenteric fistula four years following surgical repair of a ruptured aortic aneurysm. Four years thereafter the patient developed infection of the graft and required extra-anatomic bypass and excision of the infected graft. Endograft repair of aortoenteric fistula is associated with persistent infection and should be viewed as a temporizing measure. Here we present the case and review the literature regarding the treatment and outcome of this condition.