Abstract
Endovascular exclusion of aortoenteric fistula has been described as a bridge to definitive open repair surgery. However, little is known about transposing this technique to treat duodenocaval fistula. We report a case of a 20-year-old man who presented with a duodenocaval fistula arising from a metastatic nonseminomatous germ cell tumor. A staged technique using an initial endovenous exclusion of the fistula permitted stabilization of the patient and completion of his chemotherapy regimen. Subsequently, the stent graft was explanted with concomitant autogenous caval reconstruction, allowing the patient to be cancer free at 1-year follow-up.
Keywords:
Duodenocaval fistula; Endovascular treatment; Nonseminomatous germ cell tumor.
Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.
MeSH terms
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Blood Vessel Prosthesis
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Blood Vessel Prosthesis Implantation* / instrumentation
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Device Removal
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Duodenal Diseases / diagnostic imaging
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Duodenal Diseases / etiology
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Duodenal Diseases / surgery*
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Endovascular Procedures* / instrumentation
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Humans
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Intestinal Fistula / diagnostic imaging
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Intestinal Fistula / etiology
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Intestinal Fistula / surgery*
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Male
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Neoplasms, Germ Cell and Embryonal / complications*
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Neoplasms, Germ Cell and Embryonal / diagnostic imaging
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Neoplasms, Germ Cell and Embryonal / drug therapy
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Neoplasms, Germ Cell and Embryonal / secondary
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Stents
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Testicular Neoplasms / complications*
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Testicular Neoplasms / diagnostic imaging
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Testicular Neoplasms / drug therapy
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Testicular Neoplasms / pathology
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Treatment Outcome
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Vascular Fistula / diagnostic imaging
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Vascular Fistula / etiology
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Vascular Fistula / surgery*
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Vena Cava, Inferior / diagnostic imaging
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Vena Cava, Inferior / surgery*
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Young Adult
Supplementary concepts
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Nonseminomatous germ cell tumor