Infrarenal Abdominal Aortic Aneurysm: Aortoenteric Fistula

Abstract

Aortic disease continues to be a problem for the medical community and may involve any part of the aorta from the aortic valve to the iliac vessels. The need for correction of these lesions depends on the type of lesion, the patient’s symptoms, and the risk or difficulty of repair. In the abdominal aorta, the most common lesions include aneurysmal formation (especially below the renal arteries) and total aortic occlusion due primarily to the atherosclerotic disease processes – the Leriche syndrome. These lesions occur primarily in the elderly and may present as both acute and chronic situations. The acute process usually involves acute expansion, leak, or rupture of a saccular aortic aneurysm (Fig. 31.1). The chronic problem usually is a slowly progressive expansion of an aneurysm or progressive stenosis and occlusion of the distal aorta. Both endovascular and open techniques may be used to correct the problem. However, either technique may be complicated by infection or fistula formation.