A rational, structured approach to primary aortoenteric fistula.

a relatively rare but serious complication of abdominal aortic aneurysm (AAA). Since Sir Astley Cooper first described PAEF in 1822, only about 300 cases have been reported in the literature. Roux and colleagues reviewed 253 cases before 1993, and Saers and Scheltinga analyzed 81 new cases from 1994 to 2003. As both studies report, PAEF is a clinical and surgical challenge associated with a high morbidity and mortality. We report the case of a woman who presented with a PAEF and underwent a successful in situ reconstruction of the aorta. We describe the technical details that might decrease the chances of postoperative graft infection and fistula recurrence.