Duodenal obstruction following abdominal aortic reconstruction.

Four patients developed duodenal obstruction after 161 abdominal aortic reconstructions, an incidence (2.5%) rivaling that of graft infection and arterioenteric fistula. The diagnosis is easily confirmed by gastrointestinal contrast studies. Duodenal obstruction is usually caused by perigraft collagenous adhesions and is probably less likely to occur if the mobilized duodenum is not replaced directly over the aorta during resuture of the retroperitoneum. Undetected duodenal obstruction leads to rapid dehydration and electrolyte and caloric depletion.