Duodenal and aortic stenting for aortoduodenal fistula secondary to malignancy: A case report

Figure 1 Computed tomography findings. A: Contrast computed tomography scan showing immediate extravasation of contrast from abdominal aorta at level L4/5 into duodenum. It is associated with the known para-aortic metastatic nodal conglomerates with multiple gas locules noted within, diagnostic of aortoduodenal fistula; B: Three-dimensional reconstruction showing extravasation of contrast from the right lateral wall of the aorta into the 3^rd part of the duodenum.

Figure 2 Endovascular aortic repair imaging. A balloon molding of the smallest bifurcated stent-graft in the narrow aorta, to cover the aortoduodenal fistula; B: Completion angiography showed proper graft placement without extravasation or endoleak.

Figure 3 Endoscopic views of aortoduodenal fistula and stenting. A: Endoscopic intraluminal view of aortoduodenal fistula; B: Partially covered stent allows coverage of duodenal defect whilst not covering the ampulla; C: Stent anchored with endoclips to prevent migration.