Endovascular treatment of a tuberculous aneurysm of the pararenal abdominal aorta leading to an aortoduodenal fistula

This case report describes the presentation of a 79-year-old woman with no significant past medical history diagnosed with a saccular aneurysm with an aortoduodenal fistula. An emergency endovascular aneurysm repair was performed. Although the postoperative course was uneventful, 10 months after endovascular aneurysm repair, the patient died of miliary tuberculosis from mycotic aneurysms. Mycotic aneurysms are uncommon, and mycotic aneurysms caused by Mycobacterium tuberculosis are even rarer. Therefore, we believe our study makes a significant contribution to the literature given the rarity of the condition and suggests the importance of maintaining a high index of suspicion for tuberculosis as a possible cause of aortoduodenal fistula in primary mycotic aneurysm.