Retroperitoneal aortoaortic bypass for treatment of aortoduodenal syndrome

Aortoduodenal syndrome is a rare clinical entity characterized by extrinsic compression of the duodenum by an abdominal aortic aneurysm. The current surgical standard involves open aneurysm repair in a transperitoneal fashion. We describe a case of a 69-year-old man diagnosed with this syndrome who underwent successful repair using a retroperitoneal approach. The postoperative outcomes included early initiation of an oral diet, improved nutritional status, and a shorter hospital stay. We also describe the rationale leading to our decision and advocate the use of retroperitoneal surgery as the standard of care for patients presenting with aortoduodenal syndrome.