Arteriolymphatic fistula between the thoracic duct and lumbar artery pseudoaneurysm after open abdominal aortic aneurysm repair

<h2>Abstract</h2> Arterio-lymphatic fistulas are extremely rare. We describe a 76-year-old man who developed a fistulous communication between the thoracic duct and a lumbar artery pseudoaneurysm after open abdominal aortic aneurysm (AAA) repair. Only seven similar cases have been reported previously. Because the patient was asymptomatic, conservative management was selected, resulting in spontaneous thrombosis and complete resolution. This case suggests that careful observation may be an appropriate management strategy for selected postoperative arterio-lymphatic fistulas detected on follow-up imaging.