Abstract

Introduction: Aorto-Duodenal Fistulae (ADF) can be primary or secondary. Secondary ADFs are rare complications post-aortic replacement and may be diagnosed using CT scans. Based on patient stability, urgent multidisciplinary surgical management is required.
Case presentation: A 59-year-old man with haematemesis and abdominal pain was presented to the clinic’s emergency department and went into hemorrhagic shock. A CT scan confirmed secondary ADF after a prior Dacron prosthesis placement. Emergency surgery using endografts and delayed duodenal resection and reconstrution was performed. Initially improved, the patient deteriorated neurologically and died on the 14^th postoperative day.
Discussion: Secondary ADF is a rare but life-threatening complication after aortic replacement surgery. Both open and endovascular approaches can be used and the principles of damage control surgery should be applied. The case emphasizes thorough follow-up and protective measures such as omentum flaps to reduce recurrence.

Keywords:Complications; Aortic replacement surgery; Secondary aortoenteric fistula