Aorto-enteric and entero-caval fistulas represent uncommon complications following vascular surgery. These typically occur secondary to intestinal wall erosion by the prosthetic grafts and materials, and it is associated with regional inflammation and infection. We herein present a patient who developed both of these rare complications caused by a polytetrafluroethylene (PTFE) Inferior Vena Cava (IVC) graft a year after the resection of a rare metastatic Sertoli-Leydig retroperitoneal tumor and concomitant aorto-caval reconstruction. The patient presented with herald gastrointestinal bleeding and gram-negative bacteremia; and a duodenotomy, graft removal followed by IVC ligation and repeat right aorto-iliac reconstruction were performed. The patient recovered well and following the appropriate postoperative care he was discharged six days after surgery without any further vascular or gastrointestinal complications and with neoadyuvant chemotherapy.

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