Endovascular stenting as treatment for occult perforated abdominal aorta caused by acute necrotizing pancreatitis as rare complication after heart transplantation.

With an increase in the population of living cardiac allograft recipients, noncardiac surgery in this group of patients will be a more frequent phenomenon. The postoperative management in these patients is, however, complex. The authors present a case of an abdominal aortic rupture due to the involvement of a necrotizing pancreatitis caused by the side effects of immunosuppressive therapy. A 48-year-old man presented with a necrotizing pancreatitis with accidental affection of the abdominal aortic wall, necessitating emergency repair. Open surgical repair was considered too precarious in a cardiac allograft recipient, aortic stent-graft through endovascular surgery was therefore opted as the preferred procedure. The subsequent postoperative course was uneventful and patient could be discharged.