{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:15:06Z","timestamp":1784740506950,"version":"3.55.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2013,10,31]],"date-time":"2013-10-31T00:00:00Z","timestamp":1383177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION:<\/jats:title>\n                    <jats:p>Aortoenteric fistula is a rare but very serious complication of both surgical and endovascular abdominal aortic reconstruction. Since the advent of endovascular abdominal aortic aneurysm repair (EVAR), 20 cases of aortoduodenal fistula associated with aortic stent grafts have been reported.1 However, only a handful has been reported following inflammatory abdominal aortic aneurysm repair. It most commonly presents with bleeding, usually from the upper gastro-intestinal tract. With recent advances in the screening, diagnosis and management of abdominal aortic aneurysms either surgically or through an endovascular approach, the diagnosis of an aortoduodenal fistula in patients with gastro-intestinal bleeding must be suspected and excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PRESENTATION OF CASE:<\/jats:title>\n                    <jats:p>We describe a case of secondary aortoduodenal fistula that occurred two and a half years following endovascular stent graft repair of an inflammatory abdominal aortic aneurysm. We also outline the emergency correction plan and the attempts at repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>\n                      This case defies the general concept that patients with inflammatory abdominal aortic aneurysms are relatively immune to rupture. Although the presence of a peri-aneurysm thick inflammatory membrane decreases the possibility of rupture, these patients are more susceptible to other related complications such as aorto-enteric and aorto-caval fistulas.2 This case also demonstrates the peculiar presence of\n                      <jats:italic toggle=\"yes\">Streptococcus anginosus<\/jats:italic>\n                      as the pathological organism leading to graft infection and subsequent fistula, as opposed to enterococci which are often found in endograft infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Aorto-enteric fistulas are associated with a grave prognosis. Early diagnosis is crucial and extra vigilance should be taken in cases of inflammatory AAA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2013.10.016","type":"journal-article","created":{"date-parts":[[2014,8,12]],"date-time":"2014-08-12T17:34:22Z","timestamp":1407864862000},"page":"710-713","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":26,"title":["Secondary aortoduodenal fistula following endovascular repair of inflammatory abdominal aortic aneurysm due to Streptococcus anginosus infection"],"prefix":"10.1097","volume":"5","author":[{"given":"M.","family":"Zaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Tawfick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Alawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"ElKassaby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Hynes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sultan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-18-20260114","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1016\/j.jvs.2012.05.069","article-title":"Aortoduodenal fistula after endograft repair of abdominal aortic aneurysm secondary to a retained guidewire","volume":"56","author":"Houssam Farres","year":"2012","journal-title":"J Vasc Surg"},{"key":"R2-18-20260114","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1001\/jama.297.4.395","article-title":"Inflammatory abdominal aortic aneurysm","volume":"297","author":"Hellmann","year":"2007","journal-title":"J Am Med Assoc"},{"key":"R3-18-20260114","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jvs.2003.07.029","article-title":"Ruptured inflammatory abdominal aortic aneurysm: insights in clinical management and outcome","volume":"39","author":"Andrew","year":"2004","journal-title":"J Vasc Surg"},{"key":"R4-18-20260114","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/j.jvs.2012.03.253","article-title":"Comparison of open and endovascular repair of inflammatory aortic aneurysms","volume":"56","author":"Stone","year":"2012","journal-title":"J Vasc 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report","volume":"5","author":"Norgen","year":"1998","journal-title":"J Endovasc Surg"},{"key":"R12-18-20260114","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1007\/s15010-007-6040-0","article-title":"Streptococcus milleri group infection associated with digestive fistula in patients with vascular graft: report of seven cases and review","volume":"35","author":"Bonnet","year":"2007","journal-title":"Infection"},{"key":"R14-18-20260114","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.avsg.2011.05.043","article-title":"Aortic endograft infection with aortoduodenal fistula associated with adjacent vertebral body mycobacterial osteomyelitis (Pott's disease)","volume":"26","author":"Solomon","year":"2012","journal-title":"Ann Vasc Surg"},{"key":"R15-18-20260114","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.ejvs.2005.09.007","article-title":"Staged endovascular stent-grafting and surgical treatment of a secondary aortoduodenal 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