Novel surgical treatment of abdominal aortic aneurysm complicated with primary aorto-colonic fistula: A case report

RATIONALE: Primary aorto-colonic fistula is a rare complication of an abdominal aortic aneurysm. Without surgical treatment, the associated mortality rate is 100%. Even if patients receive timely surgical treatment, they may still die of complications such as infection. PATIENT CONCERNS: A 65-year-old male patient was transferred to our hospital because of massive hematochezia and abdominal pain. DIAGNOSES: Aortic computed tomography angiography demonstrated abdominal aortic aneurysm complicated with aorto-enteric fistula. INTERVENTIONS: We used a gelatin-impregnated knitted vascular prosthesis to re-establish the aneurysm in its original position combined with local drainage to treat the fistula. OUTCOMES: The patient had an uneventful postoperative course, and there was no recurrence during the 18-month follow-up. LESSONS: This surgical treatment is suitable for patients with abdominal aortic aneurysms complicated with primary aorto-colonic fistula in which the intestine is very difficult to repair or resect.