Asymptomatic Para-prosthetic Graft to Bowel Fistula Following Aorto-bifemoral Bypass Grafting Detected Incidentally

Secondary aorto-enteric fistula (SAFE) is a late but dreaded complication of abdominal aortic surgery with an overall mortality ranging from 30% to 70% in different series. Most commonly the patients with SAFE, present with the massive gastrointestinal bleed or other symptoms such as sepsis, lower extremity ischemia, abdominal pain, septic arthritis, and multicentric osteomyelitis. Treatment requires prompt diagnosis, and surgery. We present a case of para-prosthetic graft to bowel fistula in a patient who was asymptomatic and has presented for treatment of ventral wall incisional hernia.