Masuda Hiroya, Yamamoto Yu, Ae Ryusuke
Department of General Medicine, Sunagawa City Medical Center, Sunagawa, JPN.
Division of Public Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, JPN.
Cureus. 2025 Feb 22;17(2):e79483. doi: 10.7759/cureus.79483. eCollection 2025 Feb.
Arterio-enteric fistulas (AEFs) are a rare cause of gastrointestinal bleeding involving direct communication between an artery and the intestinal tract. The duodenum is the most common fistula site for AEFs, but none of the rectal cases are known. We present the case of an elderly man with hematochezia due to a rectal fistula caused by a left internal iliac artery aneurysm, which was detected on contrast-enhanced computed tomography (CT), showing typical fistula formation and ectopic gas images. This case highlights the importance of considering the occurrence of rare but potentially fatal AEFs in elderly patients with hematochezia and that the timely performance of contrast-enhanced CT is critical for an accurate diagnosis.
动脉-肠瘘（AEFs）是胃肠道出血的罕见原因，涉及动脉与肠道之间的直接连通。十二指肠是AEFs最常见的瘘管部位，但尚无直肠病例的报道。我们报告了一例老年男性因左髂内动脉瘤导致直肠瘘而出现便血的病例，该病例在对比增强计算机断层扫描（CT）中被检测到，显示出典型的瘘管形成和异位气体影像。该病例强调了在老年便血患者中考虑罕见但可能致命的AEFs发生的重要性，以及及时进行对比增强CT对于准确诊断至关重要。
