A case of aorto-colonic fistula due to aortic pseudoaneurysm presented by massive gastrointestinal bleeding

The aorto-enteric fistula is rarely occurred in patients, however it is clinically important since it is a life threatening condition in association with a massive gastrointestinal bleeding. It is classified as the primary type associated with aortic aneurysm and the secondary type which is complicated with vascular surgery. The fistula is mainly found between the aorta and the third portion of duodenum, and rarely occurred on the other part of gastrointestinal tract. In particular, to our knowledge the fistula between the aorta and transverse colon has not been reported. We report the aorto-transverse colon fistula in a 37 years old man who presented a massive lower gastrointestinal bleeding. Past history revealed that he had been stabbed in the abdomen 18 years ago, suggesting the pseudoaneurysm of aorta with fistula formation could be related. The aorto-transverse colon fistula was diagnosed by abdominal angiography and the fistula was repaired by operation.