Surgical approach for duodenocaval fistula secondary to inferior vena caval graft penetration

1 Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey 1 Department of Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey Fistula formation between the duodenum and inferior vena cava (IVC) is a rare entity. It may be diagnosed after upper gastrointestinal bleeding. Here in, we present a case of IVC graftduodenal fistula manifesting with hematemesis and melena which was diagnosed by upper gastrointestinal (GI) endoscopy. Abdominal computed tomography (CT) was reported as normal. At laparotomy, an IVC dacron graf with erosion into the adherent duodenum was explored. The graft was removed and the duodenum was repaired by doublelayer continuous suture with omental patch application. Surgery is the best therapeutic approach for treatment of dudodenocaval fistula. Double-layer continuous suture of duodenum supported by the application of an omental patch can be an option for surgical approach.