Iliac arterial-enteric fistulas occurring after pelvic irradiation.
Fistulas from the iliac artery to the bowel constitute a condition that is often lethal. Excluding fistulas related to vascular grafts, a review of previously reported cases shows that they are most often due to atherosclerotic iliac aneurysms. Three unusual cases of this condition that occurred after high-dose pelvic irradiation for treatment of cancer are presented; in no case was recurrent tumor evident. These cases suggest that high-dose pelvic irradiation can predispose to the formation of iliac arterial-enteric fistulas, particularly if sepsis or inflammation develops. The definitive surgical management of these fistulas entails bowel resection, arterial ligation, and extra-anatomic bypass.
D000328:Adult; D003108:Colonic Diseases / Q000209:etiology; D005402:Fistula / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology; D007083:Iliac Artery; D007412:Intestinal Fistula / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000528:radiation effects*