# Aortoenteric Fistula Formation From Chronic Erosion of an Axios Gastroduodenal Stent in a Patient With a History of Radiation

## TL;DR

A rare case of a life-threatening aortoenteric fistula developed in a cancer patient after a duodenal stent was placed to manage gastric outlet obstruction.

## Contribution

This case highlights the rare but severe complication of aortoenteric fistula from chronic stent erosion in a patient with a history of radiation.

## Key findings

- A 53-year-old male with stage IV colon cancer developed a life-threatening aortoenteric fistula after duodenal stenting.
- The fistula was attributed to chronic inflammation, prior radiation, and an infected psoas abscess.
- The case emphasizes the need for multidisciplinary care and vigilant monitoring when using stents for gastric outlet obstruction.

## Abstract

Gastric outlet obstruction (GOO) secondary to malignant bowel obstruction (MBO) presents significant challenges in patients with advanced cancer, often impairing quality of life and nutritional intake. This report discusses a complex case of a 53-year-old male patient with stage IV colon cancer who developed an aortoenteric fistula (AEF) as a rare, life-threatening complication following duodenal stenting for GOO management. The case highlights the multifaceted etiology of AEF, involving prior radiation, chronic inflammation, and infected psoas abscess, culminating in massive gastrointestinal hemorrhage. While duodenal stents effectively restore luminal patency and alleviate symptoms in palliative settings, vigilant monitoring is crucial to promptly identifying and addressing potential complications, such as AEF. This underscores the need for a multidisciplinary approach in managing GOO in malignancy, balancing the benefits of self-expandable metallic stents (SEMS) against alternative interventions such as gastrojejunostomy (GJ), tailored to the patient's condition and prognosis to optimize outcomes and enhance quality of life.