Secondary aortoenteric fistula in a patient with Behçet disease: Successful surgical treatment by direct suture and use of omental flap

Abstract

The aim of this report is to present a patient with Behcet disease who developed massive lower gastrointestinal tract bleeding owing to aortoenteric fistula after abdominal aorta graft reconstruction. A 34-year-old male with a history of Behcet disease for 8 months underwent surgery owing to massive hematochezia and hemodynamic instability. A fistula was observed between the proximal small intestinal segment and the aortic graft (proximal anastomosis) at the infrarenal level. The prosthesis was not removed but was wrapped with the vascularized pedicle of the omentum that passed through the mesentery of the transverse colon. The patient was discharged on the fifty-ninth day. At the 15-month follow-up appointment, the patient was in excellent condition. Although our surgical choice was not a standard approach for this type of aortoenteric fistula, it was a lifesaving procedure in our patient.