Document Detail

Internal iliac aneurysm rupture into the rectum following endovascular exclusion: an unusual cause of massive lower gastrointestinal bleeding.
MedLine Citation:
PMID:  12546595     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To report a rare iliorectal fistula following endovascular treatment of an internal iliac aneurysm. CASE REPORT: A 76-year-old man developed lower gastrointestinal bleeding 3 months after successful endovascular exclusion of a left internal iliac aneurysm with coil embolization, attempted stent-grafting, ligation of the distal external iliac artery, and a femorofemoral crossover bypass. Aortography showed no clear intestinal bleeding point, but demonstrated recanalization and continued perfusion of the aneurysm. At laparotomy, an iliorectal fistula was detected. The common iliac artery was ligated proximally, the aneurysm sac was opened, and the back-bleeding internal iliac artery branches were oversewn. The rectum was closed primarily. He made an uneventful recovery. CONCLUSIONS: An iliorectal fistula is an extremely rare and unlikely complication of coil occlusion of an iliac aneurysm. A high index of suspicion for the diagnosis is of paramount importance. Periodic imaging in these patients is required to detect recanalization and continuing aneurysm expansion.
Christos D Karkos; Taohid O Oshodi; Dale Vimalachandran; John S Abraham; Mohan Adiseshiah
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  9     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2003-01-27     Completed Date:  2003-05-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  907-11     Citation Subset:  IM    
Lancaster and Lake District Vascular Unit, Royal Lancaster Infirmary, Lancaster, UK.
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MeSH Terms
Aneurysm, Ruptured / complications,  therapy*
Embolization, Therapeutic
Gastrointestinal Hemorrhage / etiology,  therapy
Iliac Aneurysm / complications,  therapy*
Iliac Artery / injuries,  surgery
Intestinal Fistula / etiology,  therapy
Postoperative Complications / etiology,  therapy
Rectal Fistula / etiology,  therapy
Rectum / injuries,  surgery
Tomography, X-Ray Computed
Vascular Surgical Procedures*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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