An aortoduodenal fistula as a complication of immunoglobulin G4-related disease |
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Authors: | Momir Sarac Ivan Marjanovic Mihailo Bezmarevic Uros Zoranovic Stanko Petrovic Miodrag Mihajlovic |
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Institution: | Momir Sarac, Ivan Marjanovic, Uros Zoranovic, Clinic for Vascular and Endovascular Surgery, Military Medical Academy, 11000 Belgrade, SerbiaMihailo Bezmarevic, Clinic for General Surgery, Military Medical Academy, 11000 Belgrade, SerbiaStanko Petrovic, Clinic for Gastroenterology, Military Medical Academy, 11000 Belgrade, SerbiaMiodrag Mihajlovic, Institute of Radiology, Military Medical Academy, 11000 Belgrade, Serbia |
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Abstract: | Most primary aortoduodenal fistulas occur in the presence of an aortic aneurysm, which can be part of immunoglobulin G4 (IgG4)-related sclerosing disease. We present a case who underwent endovascular grafting of an aortoduodenal fistula associated with a high serum IgG4 level. A 56-year-old male underwent urgent endovascular reconstruction of an aortoduodenal fistula. The patient received antibiotics and other supportive therapy, and the postoperative course was uneventful, however, elevated levels of serum IgG, IgG4 and C-reactive protein were noted, which normalized after the introduction of steroid therapy. Control computed tomography angiography showed no endoleaks. The primary aortoduodenal fistula may have been associated with IgG4-related sclerosing disease as a possible complication of IgG4-related inflammatory aortic aneurysm. Endovascular grafting of a primary aortoduodenal fistula is an effective and minimally invasive alternative to standard surgical repair. |
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Keywords: | Abdominal aortic aneurysm Aortoduodenal fistula Endovascular repair Immunoglobulin G4-related disease |
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