Choi Sung Kyu, Kim Young Il, Park Seon Young, Ki Won Joo, Ki Ho Seok, Yoon Kyoung Won, Choi Sung Kyu, Rew Jong Sun
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Korean J Gastroenterol. 2010 Aug;56(2):113-6.
Arterio-enteric fistula is a very rare cause of massive lower gastrointestinal hemorrhage. We report here on a case of massive hematochezia caused by iliac arterio-colic 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.
动脉-肠瘘是导致大量下消化道出血的极为罕见的原因。我们在此报告一例60岁女性因髂动脉-结肠瘘引起大量便血的病例，该女性近期因腰椎间盘突出症接受了脊柱手术。腹部计算机断层扫描显示，放射性造影剂从被腹腔内脓肿包裹的右髂动脉渗入相邻扩张的结肠。此外，诊断性血管造影显示放射性造影剂通过右髂动脉与结肠之间的瘘管发生活动性外渗。尽管通过覆膜支架和弹簧圈成功地对瘘管进行了血管内封堵，但仍发生了弥散性血管内凝血和多器官功能衰竭。
