Aortoenteric fistula following elective laparoscopic cholecystectomy

Abstract

We present the case of a 71-year-old woman with gastrointestinal bleeding 21 days after undergoing elective laparoscopic cholecystectomy. Initial imaging revealed a pseudoaneurysm of nonaneurysmal infrarenal aorta, managed with an endovascular stent graft. Despite this procedure, recurrent gastrointestinal bleeding persisted, prompting further imaging that identified an aortoenteric fistula complicated by endograft infection. The fistula likely resulted from an iatrogenic injury caused by trocar entry during the cholecystectomy. Definitive surgical repair involved resection of the infected endograft and reconstruction with a bovine pericardium conduit. This case highlights the diagnostic challenges of aortoenteric fistulas, endograft infection risks, and considerations in selecting conduits for reconstruction.