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Intraoperative aspects. Image A: 1 – fourth duodenum; 2 – aortic aneurysm; 3 – proximal aortic clamping; 4 – distal aortic clamping. Image B: 1 – duodenal and 2 – aortic holes, after fistula dissection. Image C: 1 – duodenorrhaphy; 2 – aortic aneurysm; 3 – inferior mesenteric vein. Image D: 1 – Dacron aortic patch repair; 2 – local drainage tube; 3 – left renal vein.
