Iliaco-enteric fistula after robot-assisted comprehensive surgical staging of endometrial cancer: a case report

J Robot Surg. 2019 Apr;13(2):351-353. doi: 10.1007/s11701-018-0864-8. Epub 2018 Aug 20.

Abstract

Fistula formation between bowel and blood-vessel is a very rare complication after intraabdominal surgery. We report a case of iliaco-enteric fistula following robot-assisted surgical staging of endometrial cancer. A 71-year-old woman subjected to comprehensive endometrial cancer staging presented with hematochezia 35 days postoperatively. A retroperitoneal right-sided abscess and an iliaco-enteric fistula was confirmed upon imaging. The patient received endovascular repair of the aneurysm in her right common iliac artery and the segments of the small bowel containing the fistula were resected via laparotomy. If a patient presents with new onset postoperative hematochezia after pelvic and/or paraaortic lymphadenectomy, fistulation between bowel and the major abdominal blood vessels should be part of the differential diagnoses.

Keywords: Endometrial cancer; Hematochezia; Iliac artery pseudoaneurysm; Iliaco-enteric fistula; Lymphadenectomy.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / surgery*
  • Aged
  • Diagnosis, Differential
  • Endometrial Neoplasms / surgery*
  • Endovascular Procedures
  • Female
  • Gastrointestinal Hemorrhage
  • Humans
  • Hysterectomy / methods*
  • Iliac Aneurysm / diagnostic imaging
  • Iliac Aneurysm / surgery*
  • Iliac Artery / diagnostic imaging
  • Iliac Artery / surgery*
  • Intestinal Fistula / diagnostic imaging
  • Intestinal Fistula / surgery*
  • Intestine, Small / diagnostic imaging
  • Intestine, Small / surgery*
  • Laparotomy
  • Lymph Node Excision / methods*
  • Ovariectomy / methods*
  • Postoperative Complications / surgery*
  • Robotic Surgical Procedures / methods*
  • Tomography, X-Ray Computed
  • Vascular Fistula / diagnostic imaging
  • Vascular Fistula / surgery*