Abstract
An aortoduodenal fistula is a rare, lethal cause of massive gastrointestinal tract bleedings. Primary aortoduodenal fistula (PADF) is an abdominal communication between the aorta and duodenum, whereas secondary aortoduodenal fistula is usually a result of previously implanted aortic prosthetic graft repairs. We report a patient who underwent partial duodenal resection for a PADF after stent-graft repair. An 87-year-old man was referred to our hospital because of hematemesis and pre-shock state. After diagnosis of PADF, the patient had undergone stent-graft repair. After stent-graft repair, we performed a partial resection of the duodenum for preservation of stent graft infection. He died of myocardial infarction after 5 months from stent-graft repair. Conventional treatment of PADF is based on debridement, repair of the duodenal fistula, and removal of inciting factors. Frequent extra-anatomic vascular bypass procedures are necessary. Recently, some studies have reported stent-grafting for aortoduodenal fistulas. However, since there was a risk of infection after stent-graft therapy, we performed a partial resection of the duodenum. We believe strict observation is necessary because the long-term prognosis of stent-graft infection is unclear.
