Successful management of latrogenic aortoduodenal fistula by intraaortic endovascular stent-graft and duodenal diversion

Aortoduodenal fistula is usually fatal if not treated promptly. Long-term results are also not always satisfactory. A 53-year-old female patient suffered from massive hematemesis and shock due to an iatrogenic aortoduodenal fistula which was made during a laparoscopic total colectomy. Immediate closure of fistula with duodenal diversion by occlusion of duodenal lumen proximal to the fistula, bilateral truncal vagotomy and pyloroduodenojejunostomy were performed. Endoluminal aortic stent graft was inserted 3 days later. The patient remained disease-free 3 years after operation. With a prompt diagnosis, duodenal diversion with endoluminal aortic stent may be a better option for iatrogenic aortoduodenal fistula.