Duodenal stent-graft penetration: a rare cause of fatal upper gastrointestinal bleeding.

A 72-year-old woman was admitted to our department due to melena for one day. She underwent endovascular abdominal aortic aneurysm repair with stent-graft placement three years ago. On physical examination, she presented with pallor and reported epigastric pain. Laboratory tests revealed a sharp decline in hemoglobin levels from 108 g/L to 67 g/L (reference range: 130-175 g/L). Computed tomography scans demonstrated the aortic stent graft extending into the duodenal lumen. Emergency gastroscopy revealed the aortic stent migration eroding into the third part of the duodenum and causing active bleeding. The interventional radiology team deemed further endovascular intervention unfeasible. Ultimately, she requested transfer to another hospital for surgery, but died 8 days after discharge.