Aortocolic fistula, a lethal cause of lower gastrointestinal bleeding

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Abstract
Aortocolic fistula occurs with spontaneous rupture of aortic and iliac aneurysms into the sigmoid colon, or due to involvement of the aneurysmal wall by acute diverticulitis. In 8 patients reviewed, this complication proved uniformly lethal, although sufficient clinical findings were present for diagnosis, and adequate time was available for a planned therapeutic approach. Lower gastrointestinal bleeding in the patient who had an aortic aneurysm and left-lower-quadrant inflammation suggested the presence of an aortocolic fistula. Angiography should be performed during a bleeding episode to confirm the diagnosis. Surgical correction consists of an axillofemoral by pass graft, excision of the aortic aneurysm and a Hartmann procedure.