Enteric fistulation after renal artery reconstruction: a systematic literature review

A systematic literature review has revealed 14 cases of arterioenteric fistulation after renovascular reconstruction. Among the 14 patients, 9 had thrombotic occlusion of the reconstruction and 5 underwent nephrectomy, but neither procedure prevented fistulation. There was a dominance of right-sided bypass reconstructions. All patients but one suffered from gastrointestinal bleeding; 3 died before operation and 5 had herald bleeds. Three died as a direct result of surgery. Various technical solutions were used, and the follow-up time was clearly unsatisfactory; in only 2 patients was the follow-up longer than 1 year. Arterioenteric fistulation is a serious complication, associated with a high mortality rate and a high incidence of kidney loss among survivors.