Secondary Aortoenteric Erosion Followed by Recurrent Lower Extremity Abscesses

Abstract

A secondary aortoenteric fistula (SAEF) is a relatively rare complication of aortoiliac reconstructive surgery, often involving relatively fixed duodenal third portion and a vascular anastomosis. We observed a 52-year-old man with a recurrent right lower leg abscess following the erosion between ipsilateral bifurcated prosthetic graft limb and nonfixed jejunum. In situ graft-sparing surgical treatment with aggressive debridement was successfully performed. A SAEF may occur even at a nonvascular anastomosis site, or in nonfixed small bowel, and may become a source of a septic embolus. A high index of suspicion for SAEF is required for early diagnosis and treatment of this life-threatening complication.