Lower Gastrointestinal Bleeding from the Internal Iliac Artery: Angiographic Demonstration of an Iliac Arteriocolic Fistula

Abstract

A rare source of potentially massive lower gastrointestinal hemorrhage in women is advanced gynecologic malignancy. Such patients can develop gastrointestinal hemorrhage with or without prior pelvic irradiation, due to arteriocolic fistulas. Angiography permits the correct diagnosis and subsequent embolotherapy.

Arteriocolic fistulae due to a stab wound: A rare cause of lethal lower gastrointestinal bleeding

“…Iliocolic fistulae is a rare source of potentially massive lower gastrointestinal haemorrhage 6,11,13 particularly in women during advanced gynecological malignancy, 5 or in patients with pericolic abscess 4 or tumour, 12 who can develop gastrointestinal haemorrhage with or without prior pelvic irradiation. Enterovascular fistulae can also result from aneurysmal vascular adherence to the colonparticularly the aorta, iliac artery and sigmoid colon, or from a postoperative aortic complication.…”

“…1 In most cases, complications include wound infection, septicemia, and enterocutaneous fistulae. 2 Although enterovascular fistulae have been reported in the literature after colic or vascular surgery, 3 pericolic abscesses 4 and particularly in advanced gynecologic malignancy, 5,6 this type of dramatic complication has rarely been described related to stab wounds. 7 We report a case of rapidly lethal iliocolic fistulae due to a single iliac stab wound, as well as review the literature and present the various forensic characteristics.…”

Endovascular Repair of a Ruptured Internal Iliac Arterial Aneurysm With a Novel Application of the Aorto-uni-iliac Converter Device

“…12 Compression of the pelvic vessels may cause thrombophlebitis or lower extremity claudication. 14 Ileus and constipation may result from the compression of the sigmoid colon or rectum, 3,7 and incidences of massive lower gastrointestinal bleeding has been reported from the formation of an iliac arteriocolic fistula 15 or frank rupture of the IIAA into the rectum. 16 An arteriovenous fistula created by the rupture of the IIAA into an iliac vein may result in dyspnea, fatigue, and ultimately cardiac failure.…”

Inoperable Genitaltumoren der Frau: Therapeutische Optionen bei Darmstenose und -blutung

“…Besonders zu beachten ist hier jedoch die schlechte Wundheilung im vorbestrahlten Bereich, sodass eine primäre Anastomosierung nur in seltenen Ausnahmefällen in Betracht kommt. Selten kann es auch bei lokal weit fortgeschrittenen Tumoren des kleinen Beckens zu Arrosionsblutungen aus Seitenästen der A. mesenterica inferior, der A. rectalis und der A. iliaca interna und somit zu arterio-kolischen Fisteln kommen [30]. Diese Blutungen manifestieren sich meist als akute untere gastrointestinale Hämorrhagie, die endoskopisch nicht stillbar ist, sodass in dieser Situation die Notfall-Angiografie mit radiologisch-interventioneller Blutstillung (coiling, Stent) klar im Vordergrund steht [31,32].…”