Massive Lower Gastrointestinal Bleeding from an External Iliac Artery Fistula in a Patient with Bladder Cancer

Arterioenteric fistula is a rare cause of lower gastrointestinal bleeding, yet it can potentiallycause massive, life-threatening bleeding. Patients with an advanced pelvic malignancycan develop hemorrhage from an arterioenteric fistula. Selective mesenteric angiography isunable to demonstrate the source of bleeding in these patients, so evaluation of the iliacarteries is essential. We present a 67-year old man with advanced bladder cancer presentingas massive, life-threatening lower gastrointestinal bleeding from an external iliac arterial fistulato the cecum.