Aortoenteric fistula through a thrombosed graft

Objective: Unusual clinical course Background: Aortoenteric fistula is a dreadful and uncommon complication after abdominal aortic aneurysm repair. Continuous friction against the intestine and the aortic graft along with local inflammation is thought to be the major cause of aortoenteric fistula formation, although it is unexpected to have fistula formation with a thrombosed aor-tic graft. Case Report: Here, we report a case of an aortoenteric fistula between a thrombosed aortoiliac bypass graft and the duo-denum in a 75-year-old male patient who presented with a 2-month history of melena. In this case, the aorto-duodenal fistula was repaired with excision of the aortic graft, proximal and distal oversewing of the aorta, omental flap coverage, pyloric exclusion and loop gastrojejunostomy creation. Conclusions: An aortoenteric fistula can form through a thrombosed graft. Since this is not an expected route of fistula for-mation, there may be a delay in identification.