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Abstract
Arterioenteric fistula is a very rare cause of massive lower gastrointestinal hemorrhage. We report here on a case of massive hematochezia caused by iliac arteriocolic fistula in a 60-year-old woman who had a recent history of spinal surgery for herniated nucleus pulposus. Abdomen computed tomography showed the extravasation of radiocontrast media from right iliac artery encased by an intraabdominal abscess into the adjacent dilatated colon. Also, diagnostic angiography revealed the active extravasation of radiocontrast media via a fistula between right iliac artery and colon. Although successful endovascular exclusion of the fistula with stent graft and coils was performed, disseminated intravascular coagulation and multi-organ failure were developed.
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Fig. 1.
Abdominal CT scan on emergency room. (A) Non-enhancement abdomen CT scan showed a 3 cm sized soft tissue abscess with mottled air densities (arrows). (B) Post-contrast enhancement CT scan showed right iliac artery within an abscess (arrow head) and extravasation of radiocontrast media into the adjacent dilatated colon (arrows).
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