Aortoenteric fistula following renal revascularization.

Aortoduodenal fistula following renal revascularization is a rare and frequently lethal event. This report records the first known survivor of aortoenteric fistula following renal revascularization alone. Four previously reported cases followed secondary operations such as nephrectomy or autotransplantation necessitated by thrombosis of aortorenal bypass grafts. Synthetic prosthetic material led to the fistula in all instances. Infection occurred in only one. This complication may be prevented by the use of autogenous tissue grafts, monofilament suture, and interposition of viable tissue between anastomosis and gastrointestinal tract. When massive upper gastrointestinal bleeding occurs following aortic-prosthetic vascular procedures and standard studies prove nondiagnostic, prompt celiotomy is recommended.