A case of graft-duodenal fistula 25 years after operation for aortic coarctation

Abstract

A 40-year-old man who underwent extra-anatomical bypass for aortic coarctation 25 years ago was admitted to another hospital with hematemesis and melena. Esophagogastroduodenoscopy revealed no bleeding site in the stomach or the first and second portion of the duodenum. He was transferred to our hospital due to hemorrhagic shock. Angiography showed the extravasation of the contrast medium from the graft. Emergency operation was performed due to graft-duodenal fistula. In patients with previous aortic graft surgery and present gastrointestinal bleeding, graft-enteric fistula should be suspected.