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case_report·surgery, gastroenterology, cardiology, geriatrics, oncology·PMC10427754

Aortoiliac graft‐enteric fistula presenting as gastrointestinal hemorrhage: A report on a complex case management

Clinical Case Reports · 3 authors, 3 centres

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AGENT 01 · STRUCTURED SUMMARY

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TL;DR

The background included sigmoid adenocarcinoma and diverticular disease.

Full summary

706 CHARS

The background included sigmoid adenocarcinoma and diverticular disease. An acute endovascular bridging procedure was performed to achieve hemodynamic stabilization, followed by planned definitive open surgery comprising complete dacron graft explant, autologous deep vein reconstruction, and simultaneous anterior resection of the sigmoid colon. Postoperative complications included ileus requiring 21 days of total parenteral nutrition, hospital-acquired pneumonia, wound dehiscence requiring emergency relook laparotomy, right cerebellar embolic-type infarction, and thigh seroma. The total hospital stay was 30 days. The patient made a full recovery and was clinically well at 3- and 6-month follow-up.

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case_report

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surgery

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ORIGINAL PAPER

PMC10427754

Aortoiliac graft‐enteric fistula presenting as gastrointestinal hemorrhage: A report on a complex case management

Clinical Case Reports

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ABSTRACT

Abstract Key Clinical Message Iliac artery‐enteric fistula is a rare cause of lower GI bleeding and can cause life‐threatening consequences. A high degree of clinical suspicion is needed in patients with previous aortic surgery to allow early multidisciplinary intervention. Abstract This case study discusses the staged management of a 78‐year‐old patient presenting with life‐threatening lower gastrointestinal (GI) bleeding secondary to an aortoiliac graft‐enteric fistula (GEF) into the sigmoid colon on the background of an adenocarcinoma and diverticular disease. The patient had an aorto bi‐iliac synthetic dacron graft repair of an abdominal aortic aneurysm (AAA) some 20 years ago. Here, we present a case of successful endovascular treatment of massive hemorrhage as a bridge to definitive second‐stage dacron graft explant and autologous vein reconstruction with a simultaneous anterior resection. Keywords: artery‐enteric fistula, gastrointestinal hemorrhage, graft explant, sigmoid cancer

CITATION EXPORT

Michael Azzopardi, Tom Wallace, Yazan S Khaled. Aortoiliac graft‐enteric fistula presenting as gastrointestinal hemorrhage: A report on a complex case management. Clinical Case Reports. (2023). https://doi.org/10.1002/ccr3.7801

AUTHORS

3 · 3 CENTRES

Michael Azzopardi, Tom Wallace, Yazan S Khaled

1 Department of Academic Surgery, Leeds Institute of Medical Research, St James's University Hospital, Leeds, UK
2 Department of Vascular Surgery, Leeds Vascular Institute, Leeds General Infirmary, Leeds, UK
3 School of Medicine, University of Leeds, Leeds, UK