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Il Giornale Italiano di Radiologia Medica 2019 Marzo-Aprile;6(2):138-42
DOI: 10.23736/S2283-8376.19.00199-2
Copyright © 2019 EDIZIONI MINERVA MEDICA
language: English, Italian
Hematochezia in patient with iliac-cholic fistula
Maria PETULLÀ, Francesco MANTI, Giuseppe MAZZARELLA, Ottavia RUSSO, Saverio GUALTIERI, Domenico LAGANÀ ✉
Division of Radiology, Department of Clinical and Experimental Medicine, “Magna Græcia” University, Catanzaro, Italy
Iliac arterio-colic fistula is a usually secondary pathological condition, which occurs as a complication of several diseases. In 2% of cases complicated diverticular disease can lead to the onset of fistula. It presents a symptomatologic pattern characterized by decrease in hemoglobin and gastrointestinal hemorrhage and represents an important diagnostic challenge to be investigated with computed tomography (CT) abdomen with contrast medium. The main therapeutic approach is represented by the endovascular percutaneous positioning of a covered stent at the level of the origin of the fistula. We introduce the case of a 69-year-old patient who, after receiving the diagnosis of iliac-cholic fistula with an abdomen CT with contrast medium was effectively treated with the placement of a covered stent and was able, secondarily, to perform an elective surgery to solve the complicated diverticular disease.
KEY WORDS: Fistula; Gastrointestinal hemorrhage; Stents; Diverticular diseases; Abdominal pain