Primary Iliac‐appendiceal Fistula

Abstract

Primary aorto‐appendiceal fistula has been reported only once previously. A further case is presented in which bleeding. per rectum. occurred in association with rupture of an aorto‐iliac aneurysm adherent to an acutely inflamed appendix. Postoperatively the patient had several complications including permanent asynimetrical L, paraplegia and delayed presentation of an intramedullary abscess of the femur which grew Bacteroirdes fiqilis organisms. These complications highlight the high morbidity associated with nortocolic fistulae.

Fistulae involving the appendix: a systematic review of the literature

“…46 Of the patients with fistulae to the skin, 3,4,8,58-89 three of these were within Amyand (inguinal) hernias, 3,66 of which one patient also had a history of Hirschsprung's disease, 4 and another case projected from a De Gangerot (femoral) hernia. 83 The fistulae to vascular structures comprised 14 to the aorta 10,[90][91][92][93][94][95][96][97][98][99][100][101][102] and five to the iliac artery. [103][104][105][106][107] Appendiceal fistulae to the GI tract included 10 cases to the sigmoid colon alone, [108][109][110][111][112][113][114][115][116][117] with an additional two concurrently fistulating to the bladder.…”

“…Only two cases of primary aorto‐appendiceal fistula have been identified, and both were due to acute appendicitis in patients with abdominal aortic aneurysms . A similar case of a primary fistula to an iliac artery aneurysm has also been reported …”

Endovascular Techniques in the Management of Acute Arterioenteric Fistulas

“…Only 4 other cases of arterial infections or aortoenteric fistulas due to appendicitis have been reported. 1,[6][7][8] In almost all cases, sepsis of a pre-existing aortic aneurysm was involved, 6,7 and only once was a mycotic aneurysm caused by bacteriemia secondary to acute appendicitis demonstrated. 8 Similarly rare are arterioenteric fistulas after radiation therapy, in which the more common complications in large arteries are stenoses and occlusions or, less frequently, perforations and pseudoaneurysms.…”

Recto-Femoral Fistula Presenting as Emphysematous Cellulitis of the Knee: A Case Report & Literature Review

“…However, the results of surgical treatment depend mostly on its prompt recognition, the judgement, and the surgical skill of the surgeon [3, 5, 7]. Due to the increased postoperative morbidity and mortality, such patients require intense postoperative medical and nursing care [3, 8].…”