Successful endovascular treatment of duodenal obstruction caused by large abdominal aortic aneurysm. 
Abdominal aortic aneurysm (AAA) causing duodenal obstruction is not a common presentation.  Our literature review demonstrated that open surgery was often used to treat such problem.  Here, we describe the first case of an endovascular approach to treat acute duodenal obstruction caused by a massive infrarenal AAA.  An 84-year-old man presented with acute abdominal pain and distension, vomiting, decreasing appetite, and weight loss.  Computed tomography scan confirmed a large infrarenal AAA causing duodenal obstruction.  The patient was started on total parenteral nutrition, and the aneurysm treated by endovascular aneurysm repair (EVAR).  Postoperatively, the patient's symptoms of duodenal obstruction gradually resolved.  EVAR is a viable treatment option for patients presenting with duodenal obstruction caused by AAA.