Aortocystoduodenal fistula: rare complication of pancreatic pseudocyst

W. F. Sindelar and G. R. Mason

An upper gastrointestinal tract hemorrhage resulting from an aortocystoduodenal fistula developed in a patient with a pancreatic pseudocyst. The fistula was exposed through a duodenotomy, necrotic material was debrided from the pseudocyst and the aortic wall, the aortic defect was closed primarily, and the pseudocyst was drained through a cystoduodenostomy. The case is discussed as a rare hemorrhagic complication of pancreatic pseudocysts and as an illustration that under certain circumstances of infection in areas where aortic bypass can be difficult to perform, primary vascular repair can be a successful method of managing aortoenteric fistulas.