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An iliac-appendiceal fistula causing gastrointestinal bleeding.

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Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Surgical Complications

Background:

  • Aortoenteric fistulas are rare but serious complications following aortic reconstruction.
  • Iliac-appendiceal fistulas represent an even rarer subset of these vascular complications.
  • Gastrointestinal bleeding is a primary clinical manifestation.

Observation:

  • A patient presented with gastrointestinal bleeding months post-aortic reconstruction.
  • Diagnostic workup localized the bleeding source to the appendiceal orifice.
  • An iliac-appendiceal fistula was identified as the underlying cause.

Findings:

  • The patient underwent a successful appendectomy and a two-stage repair of the iliac graft.
  • Definitive treatment involved addressing both the appendiceal and vascular components.
  • The patient experienced a complete recovery without further bleeding events.

Implications:

  • This case underscores the importance of considering rare fistulas in patients with prior vascular surgery presenting with GI bleeding.
  • A high index of suspicion is crucial for timely diagnosis and intervention.
  • Early recognition and management can prevent potentially fatal outcomes associated with aortoenteric and iliac-appendiceal fistulas.