Aortoenteric fistula following elective laparoscopic cholecystectomy

We present the case of a 71-year-old woman with gastrointestinal bleeding 21 days after undergoing elective laparoscopic cholecystectomy. Initial imaging revealed a pseudoaneurysm of nonaneurysmal infrarenal aorta, managed with an endovascular stent graft. Despite this procedure, recurrent gastroint...

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Main Authors: Laura Tupper-Ring, MRM, Lauren Mills, MPH, Joey McDonald, MD, FRCSC, Chris Lightfoot, MD, FRCPC, Scott Livingstone, MD, FRCSC, Samuel Jessula, MDCM, MSc, FRCSC
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468428725000437
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author Laura Tupper-Ring, MRM
Lauren Mills, MPH
Joey McDonald, MD, FRCSC
Chris Lightfoot, MD, FRCPC
Scott Livingstone, MD, FRCSC
Samuel Jessula, MDCM, MSc, FRCSC
author_facet Laura Tupper-Ring, MRM
Lauren Mills, MPH
Joey McDonald, MD, FRCSC
Chris Lightfoot, MD, FRCPC
Scott Livingstone, MD, FRCSC
Samuel Jessula, MDCM, MSc, FRCSC
author_sort Laura Tupper-Ring, MRM
collection DOAJ
description We present the case of a 71-year-old woman with gastrointestinal bleeding 21 days after undergoing elective laparoscopic cholecystectomy. Initial imaging revealed a pseudoaneurysm of nonaneurysmal infrarenal aorta, managed with an endovascular stent graft. Despite this procedure, recurrent gastrointestinal bleeding persisted, prompting further imaging that identified an aortoenteric fistula complicated by endograft infection. The fistula likely resulted from an iatrogenic injury caused by trocar entry during the cholecystectomy. Definitive surgical repair involved resection of the infected endograft and reconstruction with a bovine pericardium conduit. This case highlights the diagnostic challenges of aortoenteric fistulas, endograft infection risks, and considerations in selecting conduits for reconstruction.
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series Journal of Vascular Surgery Cases and Innovative Techniques
spelling doaj-art-583b4a585ad643dbbd61a31fc38e64322025-08-20T02:57:21ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872025-06-0111310176110.1016/j.jvscit.2025.101761Aortoenteric fistula following elective laparoscopic cholecystectomyLaura Tupper-Ring, MRM0Lauren Mills, MPH1Joey McDonald, MD, FRCSC2Chris Lightfoot, MD, FRCPC3Scott Livingstone, MD, FRCSC4Samuel Jessula, MDCM, MSc, FRCSC5Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, CanadaFaculty of Medicine, Dalhousie University, Halifax, Nova Scotia, CanadaDivision of Vascular Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, CanadaDepartment of Interventional Radiology, Dalhousie University, Halifax, Nova Scotia, CanadaDivision of General Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, CanadaDivision of Vascular Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada; Correspondence: Samuel Jessula, MDCM, MSc, FRCSC, Division of Vascular Surgery, Room 4719, 1796 Summer St, Halifax, Nova Scotia B3H1A7We present the case of a 71-year-old woman with gastrointestinal bleeding 21 days after undergoing elective laparoscopic cholecystectomy. Initial imaging revealed a pseudoaneurysm of nonaneurysmal infrarenal aorta, managed with an endovascular stent graft. Despite this procedure, recurrent gastrointestinal bleeding persisted, prompting further imaging that identified an aortoenteric fistula complicated by endograft infection. The fistula likely resulted from an iatrogenic injury caused by trocar entry during the cholecystectomy. Definitive surgical repair involved resection of the infected endograft and reconstruction with a bovine pericardium conduit. This case highlights the diagnostic challenges of aortoenteric fistulas, endograft infection risks, and considerations in selecting conduits for reconstruction.http://www.sciencedirect.com/science/article/pii/S2468428725000437Aortoentric fistulaBovine graftIatrogenic injury
spellingShingle Laura Tupper-Ring, MRM
Lauren Mills, MPH
Joey McDonald, MD, FRCSC
Chris Lightfoot, MD, FRCPC
Scott Livingstone, MD, FRCSC
Samuel Jessula, MDCM, MSc, FRCSC
Aortoenteric fistula following elective laparoscopic cholecystectomy
Journal of Vascular Surgery Cases and Innovative Techniques
Aortoentric fistula
Bovine graft
Iatrogenic injury
title Aortoenteric fistula following elective laparoscopic cholecystectomy
title_full Aortoenteric fistula following elective laparoscopic cholecystectomy
title_fullStr Aortoenteric fistula following elective laparoscopic cholecystectomy
title_full_unstemmed Aortoenteric fistula following elective laparoscopic cholecystectomy
title_short Aortoenteric fistula following elective laparoscopic cholecystectomy
title_sort aortoenteric fistula following elective laparoscopic cholecystectomy
topic Aortoentric fistula
Bovine graft
Iatrogenic injury
url http://www.sciencedirect.com/science/article/pii/S2468428725000437
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