Aortoenteric fistula after endovascular mycotic aortic aneurysm exclusion: lessons learned during the COVID-19 era.
We report a case of aortoenteric fistula 2 years following endovascular aortic aneurysm repair (EVAR) for mycotic aneurysm presenting as upper gastrointestinal bleeding. Initial CT angiogram did not reveal the bleeding or connection to bowel, but endoscopy was suspicious of endograft in the duodenum. Management required a multidisciplinary approach. To stabilise the patient and to control bleeding, a 'bridging' endograft extension was performed. This was followed by open surgical removal of the EVAR endograft and lower limb in situ revascularisation. During postoperative recovery, the patient developed atypical, staged multisystemic symptoms (cardiac, pulmonary and neurological). With increasing awareness of the COVID-19 pandemic, the patient was found SARS-CoV-2-positive, which explained the progression of his symptoms. This was also reflected on other case reports in literature later.
['Hassan|Ahmed|A|http://orcid.org/0000-0002-5281-6912', 'Khan|Aazeb|A|', 'Huasen|Bella|B|', 'Banihani|Mohamed|M|']
D000368:Aged D000785:Aneurysm, Infected D000900:Anti-Bacterial Agents D001011:Aorta D017544:Aortic Aneurysm, Abdominal D000086382:COVID-19 D000087123:COVID-19 Nucleic Acid Testing D000072226:Computed Tomography Angiography D045422:Continuous Positive Airway Pressure D057510:Endovascular Procedures D006801:Humans D007412:Intestinal Fistula D008297:Male D000086402:SARS-CoV-2 D016157:Vascular Fistula
GI bleeding interstitial lung disease interventional radiology vascular surgery