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[A case of Crohn's disease with iliac arterio-enteric fistulae]

Jae Hak Kim1, Won Ho Kim, Chang Hwan Choi

  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.

The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi
|October 9, 2003
PubMed

Insights

A rare iliac arterioenteric fistula caused severe gastrointestinal bleeding in a Crohn's disease patient. Surgical intervention successfully stopped the hemorrhage, maintaining remission for three years with mesalazine.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Diagnostic Imaging

Background:

  • Arterioenteric fistulas are uncommon but critical complications.
  • Crohn's disease poses a risk for developing such fistulas.
  • Massive gastrointestinal hemorrhage necessitates prompt diagnosis and management.

Observation:

  • A 36-year-old male with Crohn's disease presented with severe lower gastrointestinal bleeding.
  • The patient required substantial blood transfusions (16 units of packed RBCs).
  • Radioisotope red blood cell (RBC) scan indicated bleeding from the right iliac artery.

Findings:

  • Emergent surgery confirmed an iliac arterioenteric fistula with active bleeding.
  • Surgical repair effectively controlled the hemorrhage.
  • The patient achieved sustained remission for 3 years on mesalazine therapy.

Implications:

  • This case highlights the importance of considering arterioenteric fistula in Crohn's patients with obscure GI bleeding.
  • Early diagnosis via imaging and prompt surgical intervention are crucial for survival.
  • Effective long-term management of Crohn's disease may prevent recurrence of such complications.

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