Work

Dual complications of type I endoleak and aorto-enteric fistula post-EVAR: A case report and review of literature

Year: 2026

Type: article

Abstract: Aortoenteric fistula (AEF) is a rare but life-threatening complication following endovascular aortic repair (EVAR). Although individual complications such as endoleak and graft infection are well described, the simultaneous occurrence of an endoleak and AEF is exceedingly uncommon and poses significant diagnostic and therapeutic challenges. Most reported cases of this dual complication involve type II endoleaks; to our knowledge, this represents the first reported case of a type I endoleak occurring in conjunction with an AEF, specifically an aortocolic fistula. We describe a 94-year-old woman who presented with abdominal pain and sepsis 1 year after undergoing EVAR for a ruptured infrarenal abdominal aortic aneurysm. Contrast-enhanced computed tomography (CT) demonstrated a type I endoleak with associated graft infection and imaging findings highly suggestive of an aortoenteric fistula. This case adds to the limited existing literature and underscores the importance of maintaining a high index of suspicion for this potentially fatal dual complication, while highlighting the critical role of cross-sectional imaging in timely diagnosis and in guiding appropriate clinical management.

Source: Radiology Case Reports

DOI: 10.1016/j.radcr.2026.01.034

Authors: Abel Tsehay Abebe, Sunskruthi Krishna, Peeyush Bhargava

Institution: The University of Texas Medical Branch at Galveston

Language: English

Topic: Infectious Aortic and Vascular Conditions

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $600