External Iliac Arteriovenous Fistula Caused by Stab Wound

Major abdominal arteriovenous fistula (AVF), including external iliac vessels, is a rare condition. If untreated long term, AVFs may cause venous hypertension and heart failure. We report the case of a 47-year-old man who stabbed his left lower abdomen. His vital signs were stable. Computed tomography revealed hemoperitoneum and a left external iliac AVF. Prior to laparotomy, endovascular repair of AVF was performed. Subsequent laparotomy was performed, and omental injury and a small bowel injury were repaired. Exploration of the retroperitoneal hematoma showed no bleeding from the external iliac vessels. The patient was discharged on day 6. In the management of retroperitoneal hematoma after penetrating trauma, laparotomy has been recommended. Among hemodynamically stable patients with stab wounds and traumatic external iliac AVF, endovascular intervention may be considered prior to laparotomy. Further investigations are required to reveal the long-term safety and durability of a covered stent for traumatic AVFs.