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Successful bridge therapy with initial endovascular repair for arterioenteric fistula resulting from pseudoaneurysm rupture with massive gastrointestinal hemorrhage after pancreas transplantation.
Annals of Vascular Surgery 2019 January 32
Pseudoaneurysm after pancreas transplantation has a reported incidence of 1.4% to 8.0% and may be caused by perioperative infection. Subsequent pseudoaneurysm rupture is a rare cause of arterioenteric fistula. Only 28 cases of arterioenteric fistula after pancreas transplantation have been reported in the past 20 years. We experienced a rare case of arterioenteric fistula resulting from pseudoaneurysm rupture after pancreas transplantation. We successfully treated the arterioenteric fistula with multi-staged bridge therapy composed of initial endovascular aneurysm repair, secondary isolation of the fistula, and definitive open repair with extra-anatomic bypass. No complications occurred in 1 year of follow-up; this staged therapy seems feasible for patients with arterioenteric fistula.
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