Aortoduodenal fistula: A case report and review of literature

Table 1 Summary of studies on aortoduodenal fistula repair focusing on duodenal repair techniques and outcomes (2000-2025)

Ref.	Study design, patient characteristics	Surgical technique	Outcomes
Jung et al[18], 2025	Single-center retrospective, n = 15	Primary repair (n = 8) vs duodeno-jejunostomy (n = 7)	The median duration of hospital stay was 32.7 days. 3 patients died after surgery; 11 patients survived until the last follow-up; leak in 3 (1 duodenal stump leakage, 2 died)
Piñerúa-Gonsálvez et al[19], 2025	Case report, M, 69	Duodeno-jejunostomy	Uneventful post- operative recovery
Sakakibara et al[20], 2024	Case report, F, 76	Duodeno-jejunostomy and Braun anastomosis	No recurrence after 16 months
Koliakos et al[21], 2023	Systematic review, n = 189	Primary bowel repair in 145 pts (76.7%), duodenectomy in 25 (13.2%), and no bowel repair in 19 (10.1%); additional omentoplasty in 65 pts (34.6%)	Mortality was comparable in any type of bowel repair (28% after duodenectomy, 29% after primary repair) and 21.1% after no bowel repair
Tsuneki et al[22], 2022	Case report, M, 75	Duodeno-jejunostomy	Lymphatic fistula that required lipiodol lymphangiography
Koo et al[23], 2022	Case report, M, 82	Duodeno-jejunostomy	Post-operative course uneventful
Khefacha et al[24], 2022	Case report, M, 67, SADF associated with necrotizing fasciitis of the thigh	Duodeno-jejunostomy	Died the next day due to multiple organ failure
Omran et al[25], 2021	Single-center retrospective, n = 24	Primary repair (n = 15); duodenal resection and GI reconstruction (technique not mentioned) (n = 6)	Duodenal leakage in 1 case
Tsuneki et al[26], 2020	Case report, M, 84	Duodeno-jejunostomy	No relapse 3 years after surgery
Makimoto et al[27], 2020	Case reports, 1 M, 64, and 2 M, 76	1 duodeno-jejunostomy and 2 primary repair	Post-operative course uneventful
Petrunić et al[28], 2020	Case report, M, 62	Primary repair	Laparotomy due to bleeding, 5th post-operative day
Malekpour et al[29], 2020	Case report, M, 75	Omental flap coverage, pyloric exclusion, and loop gastrojejunostomy	Post-operative course uneventful
Park et al[30], 2018	Case report, asymptomatic, M, 72	Primary repair	Post-operative course uneventful
Howard et al[31], 2015	Single-center retrospective, n = 14	Primary repair (n = 7), resection with primary anastomosis (n = 4), duodenal exclusion with gastrojejunostomy (n = 2)	Bile leak in 38% (n = 5), 43% primary repair vs 50% resection. The occurrence of bile leak after SADF repair was associated with increased mortality from 13% to 40%
Moulakakis et al[32], 2015	Case report, M, 74	Duodeno-jejunostomy	No relapse 20 months after surgery
Iwaki et al[33], 2015	Case report, M, 50	Duodeno-jejunostomy
Rodrigues dos Santos et al[34], 2014	Review, enteric repair in 331 cases of aortoduodenal fistula	Duodenorrhaphy (± omentum interposition) (n = 266), duodenal resection/reconstruction (n = 54), abdominal drainage (n = 4) cases, and no repair (n = 7)	Higher rates of fistula recurrence were reported with simple repair (41.8%); omental interposition was associated with lower mortality, independent of the repair technique
Farres et al[35], 2012	Case report, M, 76	Primary repair	Asymptomatic at 1-year follow-up
Tsujimoto et al[36], 2011	Case report, M, 73	Duodeno-jejunostomy	Uneventful recovery
Wijeyaratne et al[37], 2009	Case report, M, 65	Primary repair	Asymptomatic after 9 months
Antoniadis et al[38], 2009	Case report, M, 67	Primary repair	Asymptomatic after 4 months
Grassia et al[39], 2009	Case report, M, 72	Primary repair and omental patch	Post-operative course uneventful
Geraci et al[40], 2008	Case report, M, 59	Gastrojejunal Roux anastomosis	Asymptomatic after 6 months
Mohammadzade et al[41], 2007	Case report, M, 70	Primary repair	Post-operative course uneventful
Biancari et al[42], 2006	Case report, M, 58	Primary repair	Asymptomatic after 8 months

M: Male; F: Female; SADF: Secondary aortoduodenal fistula; pts: Patients.