[Secondary aortoduodenal fistula. Repeat aortic prosthetic repair with duodenal resection (case report)]

A secondary aortoduodenal fistula is a rare, difficult-to-diagnose and often fatal complication in aortic surgery. We herein describe a clinical case concerning surgical treatment of a male patient presenting with an aortoduodenal fistula manifesting as relapsing gastrointestinal bleeding 7 years after abdominal aortic aneurysm repair. Comparing the findings of a comprehensive examination (endoscopic and roentgenological) with the clinical picture and anamnestic data made it possible to avoid mistakes at the diagnostic stage, as well as to choose an appropriate method of surgical treatment, i. e., performing repeat prosthetic repair of the aorta via a thoracoabdominal approach using a synthetic graft (silver-impregnated) with duodenal resection.