Surgical Treatment for a Primary Arterioenteric Fistula between a Common Iliac Artery Aneurysm and the Terminal Ileum with Massive Bleeding / 대한흉부외과학회지

ABSTRACT

A 72-year-old man with progressive, unexplained lower gastrointestinal bleeding presented to the emergency department with abdominal pain and shock. Computed tomography of the abdomen showed a fistula between a right common iliac artery aneurysm and the small intestine. Laparotomy demonstrated a saccular aneurysm of the common iliac artery with a fistulous communication to the terminal ileum. Aneurysmectomy, aortoiliac graft replacement and segmental ileocecal resection with end-to-side anastomosis were all successfully performed. For a patient having an arterioenteric fistula along with lower gastrointestinal bleeding, making an early diagnosis using computed tomography and then performing immediate surgery can be expected to save the patient's life.