Graft-enteric fistulas and erosions

From 1971 to 1983, we treated eight patients with graft-enteric fistulas and one patient with graft-enteric erosion after implantation of Dacron vascular prostheses. The lesions became symptomatic from two weeks to 58 months after implantation. A graft-duodenal fistula was seen in six of the patients, one fistula occurred between the graft and jejunum and one was present between the graft and sigmoid colon. The erosion occurred between the graft and duodenum. In seven patients, infection was present. Eight patients are presently alive. A graft-enteric fistula should be suspected in all patients with grafts in the aortoiliac segment and bleeding in the gastrointestinal tract or signs of infection of unclear origin. Laparotomy should be offered at wide indications since failure to recognize the situation leads to the death of the patient.