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Published on: October 29, 2014
Mycotic Aneurysm with Iliac Artery-Colonic Fistula
Le Viet Dung1, Ma Mai Hien1,2, Dang-Thi Bich Nguyet1
1Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam.
Abstract:
Although mycotic (infected) aneurysms are uncommon, they can affect any artery. The most frequently involved vessel is the aorta as well as femoral and cerebral arteries. A vascular-colonic fistula from infected aneurysms is even rarer, which remains a challenge for diagnosis and treatment. In this case report, we aimed to illustrate an 89-year-old man presenting initially with an aneurysm of the right common iliac artery. Forty days later, this lesion was infected and produced fresh blood in the rectum and sigmoid colon observed by colonoscopy. The final diagnosis of this case was a right common iliac artery aneurysm-colonic fistula due to infection. The patient was successfully diagnosed and treated with surgery at our hospital.
Insights
Mycotic aneurysms are rare infections of arteries. This case highlights a rare vascular-colonic fistula from an infected iliac artery aneurysm, successfully treated with surgery.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Gastroenterology
Background:
- Mycotic aneurysms, though uncommon, can affect any artery, with the aorta, femoral, and cerebral arteries being most frequent.
- Vascular-colonic fistulas arising from infected aneurysms are exceptionally rare and pose diagnostic and therapeutic challenges.
Observation:
- An 89-year-old male presented with a right common iliac artery aneurysm.
- Forty days post-presentation, the aneurysm became infected, leading to hematochezia (fresh blood in stool) and sigmoid colon involvement.
- Colonoscopy confirmed the presence of blood in the rectum and sigmoid colon.
Findings:
- The final diagnosis was an infected right common iliac artery aneurysm with a secondary colonic fistula.
- The patient underwent successful surgical intervention for the condition.
Implications:
- This case underscores the importance of considering infectious etiologies in arterial aneurysms, particularly when unusual symptoms arise.
- Early diagnosis and surgical management are crucial for favorable outcomes in rare complications like vascular-colonic fistulas.
- Highlights the diagnostic utility of colonoscopy in identifying gastrointestinal bleeding secondary to vascular pathology.
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