A patient with three aortoenteric fistulas in a period of five years: case report

  • Josip Figl Vascular surgeon, General surgeon
  • Andrea Crkvenac Gregorek
  • Predrag Pavic
  • Irena Snajdar
  • Marko Mance
Keywords: aortoenteric fistula aortic surgery (AEF), aortic reconstruction complication, abdominal aortic aneurysm (AAA)


Background: Aortoenteric fistula (AEF) is a pathological communication between the aorta and gastrointestinal tract that presents a life-threatening condition. It can be primary or secondary, based on the underlying cause of
fistula development.

Case study: We present a 67-year-old female patient who suffered from three secondary AEFs in a period of five years. After two abdominal surgeries for gastric ulcer and colorectal adenocarcinoma (TNM stage II), the patient had an open abdominal aortic aneurysm reconstruction. For each AEF presentation, opened surgical reconstruction was performed.

Conclusion: Morbidity and mortality rates after AEF surgery are high despite advances in surgical techniques and materials. Three times recurrent AEF in a single patient with 5-years survival after initial reconstructive surgery is rare event.


Download data is not yet available.


Milner R, Minc S. Local complications: Aortoenteric Fistula. In: Cronenwett KW, Johnston KW (eds.) Rutherford's Vascular surgery. 8th ed. Philadelphia, PA: Elsevier; 2014. P673-81.

Champion MC, Sullivan SN, Coles JC, et al.: Aortoenteric fistula: incidence, presentation, recognition, and management. Ann Surg. 1982; 7059240; 195:314

Bunt TJ: Synthetic vascular graft infections: II. Graft-enteric erosions and graft-enteric fistulas. Surgery. 1983 94:1.

Elliott JP, Smith RF, Szilagyi DE: Aortoenteric and paraprostheticenteric fistulas. Arch Surg. 1974 108:479.

Tagowski M, Vieweg H, Wissgott C et al.: Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal Aorta. Radiol Res Pract. 2014 https://doi.org/10.1155/2014/383159

Hagspiel KD, Turba UC, Bozlar U et al.: Diagnosis of Aortoenteric Fistulas With CT Angiography. J Vasc Interv Radiol. 2007;18(4):497-504.

Davidovic LB, Spasic DS, Lotina SI: Aorto-enteric fistulas. Srp Arh Celok Lek. 2001 129(7-8):183-93.

Osman MF, Lyden S, Farivar B, Nazzal M, Srivastava S: Contemporary Outcomes in the Management of Aortoenteric Fistula. J Vasc Surg. 2018 68(3):47-8.

O’Hara PJ, Hertzer NR, Beven EG, et al.: Surgical management of infected abdominal aortic grafts: review of 25-year experience. J Vasc Surg. 1986 3:725.

Seeger JM, Back MR, Albright JL, et al.: Influence of patient characteristics and treatment options on outcome of patients with prosthetic aortic graft infection. AnnVasc Surg. 1999 13(4):413-20.

Kuestner LM, Reilly LM, Jicha DL, et al.: Secondary aortoenteric fistula: contemporary outcome with use of extraanatomic bypass and infected graft excision. J Vasc Surg. 1995 21:184.

Reilly LM. Prosthetic Vascular Graft Infection. In: Hallett JW Jr, Mills JL Sr, Rooke TW et al. editors. Comprehensive Vascular and Endovascular Surgery (Second Edition) 2009 pp.688-713.

How to Cite
Figl J, Crkvenac Gregorek A, Pavic P, Snajdar I, Mance M. A patient with three aortoenteric fistulas in a period of five years: case report. Acta Chir. Croat. [Internet]. 2020Oct.4 [cited 2020Oct.22];17(1):37-9. Available from: https://acc.hkd.com.hr/index.php/ACC/article/view/117
Case Reports