Recurrent sepsis resulting from an aorto-appendicular fistula

• Rare aortoenteric fistula connecting appendix to aneurysmal aorta. • Patient presented with recurrent sepsis; prior surgical history noted. • Diagnosis confirmed through CT, MRI, and exploratory laparotomy. • Surgical removal of fistula and appendix led to patient recovery. • Follow-up showed normal inflammatory parameters and stable CT findings. A 75-year-old patient with a history of endovascular aorta repair, low anterior bowel resection and small bowel resection presented with episodes of recurrent sepsis. Radiological imaging and laparotomy revealed an aortoenteric fistula connecting the appendix to the aneurysmatic aorta as the cause of the recurrent sepsis. Surgical removal of the appendix and dismantling of the fistula allowed the patient to recover. The patient in this report consented to the publication of anonymised case details and images.