EDITOR'S QUIZ: GI SNAPSHOT
EDITOR’S QUIZ: GI SNAPSHOT
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From question on page 441
Abdominal computed tomography scan demonstrated a voluminous right common iliac aneurysm adjacent to the lumen of the sigmoid. Angiography (fig 3
) confirmed this, and laparotomy showed a large aneurysm from the right common iliac artery fistulised in the sigmoid which was embedded in the pelvis. A femoral-femoral bypass grafting procedure for revascularising the right limb was completed, the thrombosed aneurysm removed, and a left colectomy without primary anastomosis was performed. Histological examination of the colectomy specimen confirmed the fistula. The patient was discharged to her local hospital on day 30.
[in a new window] Figure 3 Angiogram showing a large right iliac primary artery aneurysm.
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Vascular-enteric fistula is a rare but life threatening disease with a very high mortality. The most frequent is aorto-duodenal fistula in patients with a history of aortic graft surgery. Aorto-colonic fistula accounts for only approximately 5% of all reported cases. Most published cases are secondary
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Gut 2006 55: 441.[Extract] [Full Text] [PDF]
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