‘Keep in Mind an Endograft is a Spring!’: Re. ‘Aorto-enteric Fistula After Endovascular Repair for Behcet's Disease Patient: a Case Report’

摘要

In their paper, Arworn et al. report the case of a 42 year old male with Behcet's disease presenting with aorto-enteric fistula (AEF) following endovascular treatment of a symptomatic infrarenal abdominal aortic aneurysm (AAA).1 An endovascular approach to inflammatory AAA has become the first line therapy as it is associated with lower mortality compared with open surgery.2 Moreover, placing an endograft eliminates the suture line of open surgery that has been considered as a potential risk factor for secondary AEF when in contact with the duodenum. However, as development of an AEF has been described in endovascularly managed inflammatory AAA, even their definite aetiology is not entirely understood. The most incriminated cause is infection, which may be spread to the endograft either directly from a nearby source of infection, or haematologically from a distant source.