Arterial-colonic fistula secondary to colonic stent erosion into the left external iliac artery. Issue 1 (10th January 2023)

• Record Type: Journal Article
• Authors: Dillon, Jacquelyn; Mills, Alexandra N; Pawloski, Kate R; Scribetta, Nicholas; Greenstein, Alexander
• Is Part Of: Journal of surgical case reports. Volume 2023:Issue 1(2023)
• Publication Date: 2023-01-10
• Subjects: self-expandable metal stent -- colonic stent -- fistula; Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjac615
• Languages: English
• ISSNs: 2042-8812

Abstract

Abstract: Self-expandable metal stent (SEMS) are widely utilized as a bridge to surgical intervention and for palliative treatment of malignant bowel obstructions. The risk of complications associated with SEMS is low in well-selected patients. Stent erosion is a rare but serious adverse event that is associated with high morbidity and mortality. Here, we report the case of a 74-year-old patient with a colonic obstruction secondary to a pelvic mass that was treated with SEMS and radiotherapy, who developed a partial thickness stent erosion and recurrent hematochezia 6 years after placement. Endoscopic retrieval was not technically feasible. During attempted surgical resection, massive hemorrhage occurred from a colonic-arterial fistula to the left external iliac artery resulting in death. While SEMS remain an effective, minimally invasive approach for the management of bowel obstructions, prolonged in-situ lifetime may confer an increased risk of serious adverse events including erosion and fistula formation.