Primary arterioenteric fistula between common iliac artery and ileum with massive bleeding

Primary iliac artery aneurysms are rare, and a fistula to the terminal ileum with bleeding is very uncommon. A case with a primary massively bleeding iliaco-ileal fistula is described. In an emergency operation the common iliac artery was ligated and the fistula to the small bowel was resected. Arterial reconstruction was done by extra-anatomical femoro-femoral suprapubic prosthesis. The immediate outcome of the operation was excellent, but the patient died four days later because of acute myocardial infarction.