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Primary iliac-appendiceal fistula.

J L Chambers¹, J C Graham, M Appleberg

¹Department of Vascular Surgery, Royal North Shore Hospital, Sydney, New South Wales.

The Australian and New Zealand Journal of Surgery

|June 1, 1988

Summary

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Primary aorto-appendiceal fistula, a rare condition, involves a connection between the aorta and appendix. This case highlights severe complications, including rectal bleeding and neurological deficits, emphasizing high morbidity.

Area of Science:

Vascular Surgery
Gastroenterology
Infectious Disease

Background:

Primary aorto-appendiceal fistula is an exceedingly rare vascular anomaly.
Aortoenteric fistulas, including aortoappendiceal, are associated with high mortality and morbidity.

Observation:

A case of primary aorto-appendiceal fistula is presented.
The fistula resulted from an aorto-iliac aneurysm adherent to an acutely inflamed appendix.
The patient presented with rectal bleeding.

Findings:

Postoperative complications included permanent asymmetrical L1 paraplegia.
A delayed intramedullary abscess of the femur, caused by Bacteroides fragilis, was observed.
These complications underscore the significant morbidity associated with aortocolic fistulae.

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Implications:

This case emphasizes the critical need for prompt diagnosis and management of aorto-appendiceal fistulas.
Understanding potential postoperative complications is crucial for patient care.
The high morbidity associated with this rare condition necessitates further research and awareness.