DOI: 10.36347/sjmcr.2023.v11i01.002

Pages: 5-7

Secondary aorto-digestive fistulas are a rare but extremely serious complication of aortic prostheses. As the symptoms, if any, are often not very specific, the diagnosis is often difficult and must always be based on a whole series of justifications including medical imaging. Early diagnosis is essential and this fistula should be the first option considered in a patient with an abdominal aortic prosthesis who presents rectal bleeding or melaena (even to a small degree), sepsis and/or abdominal pain. The CT scan is the examination of choice, the criteria providing evidence of a fistula being the presence of gaseous images in a peri and intraprosthetic fluid collection, the thickening and / or retraction of the intestinal walls on contact, the existence of a false aneurysm, and finally, very rarely, the extravasation of contrast medium in the intestinal lumen. In this clinical case, we present a patient with fistulized aortofemoral prosthesis in the fourth portion of the duodenum highlighted on CT and confirmed intraoperatively.