Small bowel: Aortoenteric fistula

Aortoenteric fistula remains one of the most difficult acute care and vascular surgery challenges. Presentation is acute or chronic, and CT scanning and endoscopy are the primary modalities to confirm aortoenteric fistula. Operative management is the only solution for correction of aortoenteric fistula. The goals of operative therapy are to (1) assure arterial flow and adequate distal perfusion, (2) detach the connection between the GI track and the arterial system, (3) re-establish GI track integrity, (4) minimize risk of recurrence, and (5) definitively manage the systemic infection. A multidisciplinary approach combining the efforts of both acute care and vascular surgeons with critical care anesthesia is a key. Operative techniques and pearls are presented.