Neo Aortic Reconstruction in Management of Primary Aorto Cutaneous Fistula of Abdominal Aorta - A Rare Case

Introduction: Aorto-cutaneous fistula is a rare complication of mycotic abdominal aortic aneurysm. Aorto-cutaneous fistulas were rarely reported in the literature, and they were seen after thoracic aortic interventions, either a TEVAR or after open surgery for mycotic aortic aneurysms. Open exploration with thorough debridement and reconstruction, either in an extra-anatomical plane or in situ reconstruction using an autologous vein, was the line of treatment. Case report: We present the case of a juxtarenal saccular abdominal aortic aneurysm which resulted in the formation of a primary aorto-cutaneous fistula. Neoaortic reconstruction was done using a tubular reconstructed bovine pericardial patch as a life-saving procedure. The postoperative period was uneventful, and the patient was discharged with long-term antibiotics and regular follow-up. Conclusion: Aortocutaneous fistula is an extremely rare complication of primary abdominal mycotic aneurysm. Thorough surgical debridement with in situ reconstruction with tubular reconstructed bovine pericardium or autologous superficial femoropopliteal vein can be a life-saving procedure in such patients, with long-term antibiotic therapy.