A case of aortocolonic fistula caused by sigmoid diverticulitis | Zendy

Ryosuke Kowatari | Zendy; Hanae Sasaki | Zendy; Shintaro Goto | Zendy; Yuki Imamura | Zendy; Chikashi Aoki | Zendy; Ikuo Fukuda | Zendy

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A case of aortocolonic fistula caused by sigmoid diverticulitis

Author(s) -

Ryosuke Kowatari,

Hanae Sasaki,

Shintaro Goto,

Yuki Imamura,

Chikashi Aoki,

Ikuo Fukuda

Publication year - 2019

Publication title -

journal of vascular surgery cases and innovative techniques

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.274

H-Index - 5

ISSN - 2468-4287

DOI - 10.1016/j.jvscit.2018.12.005

Subject(s) - medicine , diverticulitis , aortoenteric fistula , sigmoid colon , abdominal aortic aneurysm , pathogenesis , fistula , surgery , revascularization , anastomosis , abdominal aorta , aneurysm , radiology , aorta , pathology , rectum , myocardial infarction

The development of a secondary aortoenteric fistula is a well-described complication after open or endovascular repair of an abdominal aortic aneurysm. However, evidence regarding aortocolonic fistulas (ACFs) and their pathogenesis is currently limited. We present a case of ACF that developed 18 years after open repair of an abdominal aortic aneurysm with atypical symptoms. The patient was successfully treated with total resection of the involved aorta, prosthetic graft, and sigmoid colon, with extra-anatomic bypass and primary anastomosis of the residual colon. Pathologic examination revealed that the pathogenesis of ACF was attributed to sigmoid diverticulitis. This case report highlights the uncommon pathogenesis of ACF and the importance of considering revascularization and intestinal reconstruction in the surgical strategy for each individual case.

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