A 74-year-old male patient underwent elective surgery for an infrarenal abdominal aortic aneurysm, performing aortic bi-iliac bypass and aneurysmorrhaphy. During the postoperative period, he presented spikes in fever, with no clinical repercussions or elevated inflammatory parameters. In the absence of a clear focus of infection, abdominopelvic CT angiography was requested (Fig. 1), revealing a fistula between the sigmoid and the aneurysm sac. The patient underwent reoperation, which included removal of the prosthesis and reconstruction with cryopreserved bifurcated aorta and a Hartmann procedure. Enterococcus faecalis and Enterococcus faecium were isolated in the surgical samples, which were treated with targeted antibiotic therapy. Immediate postoperative progress in the ICU and on the ward was favorable.
Case diagnosis: fistula between the sigmoid and aneurysm sac.
Conflict of interestNo conflicts of interest or financial ties to disclose.
