Dd. Nicolaou et Wk. Mysko, ENTERIC FISTULIZATION OF A COMMON ILIAC ARTERY ANEURYSM - AN UNUSUAL CAUSE OF GASTROINTESTINAL HEMORRHAGE AND SHOCK, The American journal of emergency medicine, 14(3), 1996, pp. 272-275
A 78 year old man with a history of recent unexplained lower gastroint
estinal bleeding presented to the emergency department with the acute
onset of abdominal pain, tenesmus, and shock. Computed tomography of t
he abdomen showed a fistula between a common iliac artery aneurysm and
the small intestine, Laparotomy demonstrated a saccular aneurysm of t
he common and proximal internal iliac arteries with fistulous communic
ation to the distal ileum, Aneurysmectomy, arteriorrhaphy, and segment
al ileal resection with primary anastomosis were successfully performe
d. This case illustrates a rare complication of an uncommon aneurysm,
emphasizing the need for emergency physicians to consider complicated
vascular disease in the evaluation of a patient with abdominal pain an
d shock. (Am J Emerg Med 1996;14:272-275. Copyright (C) 1996 by W.B. S
aunders Company)