Primary aortoduodenal fistula treated successfully with surgery in a patient with Takayasu's arteritis.

Takayasu's arteritis was originally described as a systemic inflammatory arterial disease presenting with occlusive changes. However, it has also been known to cause aneurysm formation. In this report, a patient with Takayasu's arteritis was found to have an aortoduodenal fistula. An emergency operation was carried out with resection of the saccular aneurysm and the fistula. The aorta was reconstructed with a prosthetic graft and the duodenum repaired. A pedicled omental flap was placed between the aorta and the duodenum. The postoperative recovery was uneventful, there was no evidence of persistent bleeding, and the patient was well at the 3-year follow-up. This is the first case in the English language literature of a primary aortoduodenal fistula treated successfully with surgery in a patient with Takayasu's arteritis.