Laparoscopic Aortic Injury Leading to Delayed Aortoenteric Fistula: an Alternative Technique for Repair

Complications of laparoscopic procedures occur in up to 10% of cases. The most lethal complication relates to injury of major retroperitoneal vascular structures. A case of aortoenteric fistula referred to the vascular surgical service 1 month following emergency repair of laparoscopic aortic injury is presented. A technique utilizing a saphenous vein panel graft for distal aortic repair is described. Review of reported cases demonstrates that major retroperitoneal vascular injury during laparoscopy is rare, with a reported incidence of 3 to 10/10,000 procedures, and a mortality of up to 20%. Simple suture repair is the usual form of treatment, but specialized techniques are occasionally required.