• Maoxun Huang, Hulin Piao, Yong Wang, Weitie Wang, Shibo Wei, Chulong Xie, and Kexiang Liu.
• Department of Cardiovascular Surgery, Second Hospital of Jilin University, Changchun, Jilin, China.
• Medicine (Baltimore). 2018 Aug 1; 97 (33): e11890.

RationalePrimary aorto-colonic fistula is a rare complication of an abdominal aortic aneurysm. Without surgical treatment, the associated mortality rate is 100%. Even if patients receive timely surgical treatment, they may still die of complications such as infection.Patient ConcernsA 65-year-old male patient was transferred to our hospital because of massive hematochezia and abdominal pain.DiagnosesAortic computed tomography angiography demonstrated abdominal aortic aneurysm complicated with aorto-enteric fistula.InterventionsWe used a gelatin-impregnated knitted vascular prosthesis to re-establish the aneurysm in its original position combined with local drainage to treat the fistula.OutcomesThe patient had an uneventful postoperative course, and there was no recurrence during the 18-month follow-up.LessonsThis surgical treatment is suitable for patients with abdominal aortic aneurysms complicated with primary aorto-colonic fistula in which the intestine is very difficult to repair or resect.

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