PMC6536776_01
Delayed enhanced CT on re-admission (A) demonstrated type II endoleak from third lumber artery (A). 3D reconstruction (B) (yellow arrows show third lumber artery).
gr1.jpg
PMC6536776_01_gr1.jpg
fig1
Enhanced CT demonstrated enlargement of the aneurysm sac to 4.5 cm and type II endoleak from the third and fourth right lumbar arteries (Fig. 1A and B).
Delayed enhanced CT at five years and eight months on re-admission (A, on re-admission). Two days after readmission (B), ventral protrusion of the aneurysm sac was confirmed.
gr2.jpg
PMC6536776_01_gr2.jpg
fig2
However, as CT showed ventral protrusion of the aneurysm sac two days later (Fig. 2), an emergency operation was indicated.
Intra-operative findings revealed a fistula in the third part of the duodenum (white arrows) and a defect in the aneurysm sac (black arrows).
gr3.jpg
PMC6536776_01_gr3.jpg
fig3
In the third part of the duodenum there was a small fistula resembling the mouth of a fish measuring 1x1 cm (Fig. 3).