Cirujano General

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board

>Journals >Cirujano General >Year 2017, Issue 2

Sánchez-Betancourt AA, Sibaja-Álvarez P
Recto-illiac arterio-venous fistula as the cause of recurrent rectal bleeding. Case report and brief anatomical review
Cir Gen 2017; 39 (2)

Language: Español
References: 25
Page: 110-114
PDF: 4. Kb.

Full text


Copious rectal bleeding poses a diagnostic and therapeutic challenge in the surgical wards. The main cause of lower GI bleeding is diverticular disease, but, this condition may be caused by a large number of pathological entities. With regards to rectal bleeding, the main cause of this condition is hemorrhoidal disease. We describe in this article, the case of a 31 year old male, whom after being subjected to an endoarterial embolization, was found to have an arteriovenous fistula communicating the pelvic branches of the interior iliac artery and the external rectal venous plexus. This procedure proved to be both diagnostic and therapeutic for this condition.

Key words: Rectal diseases, malformation, arteriovenous malformation.


  1. Longstreth GF. Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol [Internet]. 1997; 92: 419-424. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9068461

  2. Strate LL. Lower GI Bleeding: Epidemiology and diagnosis. Gastroenterol Clin North Am [Internet]. 2005; 34: 643-664. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16303575

  3. Kontopodis N, Spiridakis K, Grigoraki M, Panagiotakis G, Papadakis T, Kokkinakis T, et al. Colon bleeding from both arteriovenous malformation and inflammatory bowel disease. Case report. G Chir [Internet]. 2011; 32: 417-420. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22018216

  4. Gralnek IM, Ron-Tal Fisher O, Holub JL, Eisen GM. The role of colonoscopy in evaluating hematochezia: a population-based study in a large consortium of endoscopy practices. Gastrointest Endosc [Internet]. 2013; 77: 410-418. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23294756

  5. Crosland A, Jones R. Rectal bleeding: prevalence and consultation behaviour. BMJ [Internet]. 1995; 311. Available from: http://www.bmj.com/content/311/7003/486?linkType=FULL&resid=311/7003/486&journalCode=bmj

  6. Weingart SN, Stoffel EM, Chung DC, Sequist TD, Lederman RI, Pelletier SR, et al. Working up rectal bleeding in adult primary care practices. J Eval Clin Pract [Internet]. 2017; 23: 279-287. Available from: http://doi.wiley.com/10.1111/jep.12596

  7. Dahshan A. Serious rectal bleeding complicating suction rectal biopsy in a child. W V Med J [Internet]; 110: 34-35. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24902467

  8. De Beule T, Carels K, Tejpar S, Van Cleynenbreugel B, Oyen R, Maleux G. Prostatic biopsy-related rectal bleeding refractory to medical and endoscopic therapy definitively managed by catheter-directed embolotherapy: a case report. J Med Case Rep [Internet]. BioMed Central; 2015; 9: 242. Available from: http://www.ncbi.nlm.nih.gov/pubmed/265113324

  9. Beuran M, Stoica B, Tănase I, Negoi I, Păun S. Massive intraoperative bleeding after laparoscopic assisted abdominoperineal resection: a case report and systematic review of the literature. Chirurgia (Bucur) [Internet]; 110: 165-170. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26011840

  10. Popek S, Senagore A. Indwelling rectal tubes: an unusual cause of significant rectal bleeding in two critically ill patients. Am Surg [Internet]. 2013; 79: 219-220. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23336667

  11. Johansen K, Bardin J, Orloff MJ. Massive bleeding from hemorrhoidal varices in portal hypertension. JAMA J Am Med Assoc [Internet]. American Medical Association. 1980; 244: 2084. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1980.03310180050035

  12. Sylla P, Deutsch G, Luo J, Recavarren C, Kim S, Heimann TM, et al. Cavernous, arteriovenous, and mixed hemangioma–lymphangioma of the rectosigmoid: rare causes of rectal bleeding-case series and review of the literature. Int J Colorectal Dis [Internet]. 2008; 23: 653-658. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18330577

  13. Bes C, Dağlı Ü, Yılmaz F, Soy M. Massive lower gastrointestinal bleeding associated with solitary rectal ulcer in a patient with Behçet’s disease. Reumatismo [Internet]. 2015; 67: 82-84. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26492967

  14. Álvarez M, Gómez-Polo JC, Lerma JL, Lozano Mde L. Rectal bleeding and microabscesses in a not immunosuppressed patient]. Rev Esp Quimioter [Internet]. 2015; 28: 54-55. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25690146

  15. Azghari I, Bargach A, Moatassim Billah N, Essaoudi MA, Jahid A, Kabbaj N. Ileocecal resection for massive rectal bleeding due to Yersinia enterocolitica: a case report and review of the literature. J Med Case Rep [Internet]. 2016; 10: 6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26781434

  16. Smith WG, Beahrs OH, McDonald JR,. Congenital arteriovenous fistula involving both ischioanal fossae; report of case. Ann Surg [Internet]. 1957; 145: 115-118. Available from: http://www.ncbi.nlm.nih.gov/pubmed/13395291

  17. Shafik A, Mostafa H. Study of the arterial pattern of the rectum and its clinical application. Acta Anat (Basel) [Internet]. 1996; 157: 80-86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9096745

  18. Foster ME, Lancaster JF, Leaper DJ. Functional aspects of ano-rectal vascularity. Acta Anat (Basel) [Internet]. 1985; 123: 30-33. Available from: http://www.ncbi.nlm.nih.gov/pubmed/4050305

  19. Drummond H. The arterial supply of the rectum and pelvic colon. Br J Surg [Internet]. 1913; 1: 677-685. Available from: http://doi.wiley.com/10.1002/bjs.1800010417

  20. DiDio LJ, Diaz-Franco C, Schemainda R, Bezerra AJ. Morphology of the middle rectal arteries. A study of 30 cadaveric dissections. Surg Radiol Anat [Internet]. 1986; 8: 229-236. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3107146

  21. Ayoub SF. Arterial supply to the human rectum. Acta Anat (Basel) [Internet]. 1978; 100: 317-327. Available from: http://www.ncbi.nlm.nih.gov/pubmed/619506

  22. Bilhim T, Pereira JA, Tinto HR, Fernandes L, Duarte M, O’Neill JE, et al. Middle rectal artery: Myth or reality? Retrospective study with CT angiography and digital subtraction angiography. Surg Radiol Anat [Internet]. 2013; 35: 517-522. Available from: http://link.springer.com/10.1007/s00276-012-1068-y

  23. Sato K, Sato T. The vascular and neuronal composition of the lateral ligament of the rectum and the rectosacral fascia. Surg Radiol Anat. 1991; 13: 17-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2053040

  24. Caggiati A, Bergan JJ, Gloviczki P, Eklof B, Allegra C, Partsch H, et al. Nomenclature of the veins of the lower limb: Extensions, refinements, and clinical application. J Vasc Surg [Internet]. Churchill Livingstone Inc, New York; 2005; 41: 719-724. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0741521405001217

  25. Dujovny N, Quiros RM, Saclarides TJ. Anorectal anatomy and embryology. Surg Oncol Clin N Am. 2004; 13: 277-293.

>Journals >Cirujano General >Year 2017, Issue 2

· Journal Index 
· Links 

Copyright 2019