{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:02:24Z","timestamp":1756425744031,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,17]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>We present a case of a 60-year-old woman status post failed pancreatic transplant, presenting with right lower extremity pain and large volume rectal bleeding. The team initiated a massive transfusion protocol. Investigations revealed an arterioenteric (AE) fistula between the right external iliac artery and terminal ileum. The patient was then emergently sent for right iliac artery stent placement, successfully stopping the active arterial haemorrhage. Afterwards, the surgical team transected the pancreatic jejunal anastomosis, subsequently resecting 7 cm of jejunum. On postoperative day 1, the patient became unstable, going into disseminated intravascular coagulation evidenced by low platelet count, elevated prothrombin time and bloody output from multiple sites. Resuscitation with pressors and blood product transfusion was unsuccessful. She was made comfort measures only and expired shortly after extubation. Although a rare aetiology, it is important to consider AE fistulas in patients presenting with vascular and gastrointestinal symptoms in the setting of a failed allograft.<\/jats:p>","DOI":"10.1136\/bcr-2021-242549","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T12:50:25Z","timestamp":1626180625000},"page":"e242549","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Critical presentation and management of an acute gastrointestinal haemorrhage as a result of an arterioenteric fistula secondary to a failed pancreatic allograft"],"prefix":"10.1136","volume":"14","author":[{"given":"Anastasia","family":"Naritsin","sequence":"first","affiliation":[{"name":"Internal Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Peck","sequence":"additional","affiliation":[{"name":"Emergency Department, Southern New Hampshire Medical Center, Nashua, New Hampshire, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,13]]},"reference":[{"key":"2025082722510832000_14.7.e242549.1","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s13244-010-0046-3","article-title":"Pancreatic transplantation: surgical technique, normal radiological appearances and complications","volume":"1","author":"Hampson","year":"2010","journal-title":"Insights Imaging"},{"key":"2025082722510832000_14.7.e242549.2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1148\/radiol.15131585","article-title":"Pancreas transplant imaging: how I do it","volume":"275","author":"Tolat","year":"2015","journal-title":"Radiology"},{"key":"2025082722510832000_14.7.e242549.3","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2013.138"},{"key":"2025082722510832000_14.7.e242549.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-007-9267-3"},{"key":"2025082722510832000_14.7.e242549.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2011.01560.x"},{"key":"2025082722510832000_14.7.e242549.6","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1007\/s00270-012-0354-8","article-title":"Life-Threatening Arterioenteric fistula bleeding treated by embolization","volume":"35","author":"Duvnjak","year":"2012","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2025082722510832000_14.7.e242549.7","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S0377-1237(05)80020-6","article-title":"Arterio-enteric Fistula - An Unusual Complication of Improper Wound Closure","volume":"61","author":"Gupta","year":"2005","journal-title":"Med J Armed Forces India"},{"key":"2025082722510832000_14.7.e242549.8","doi-asserted-by":"crossref","first-page":"065","DOI":"10.1055\/s-0033-1349169","article-title":"Arterio-enteric fistula in failed enteric-drained pancreas transplants: an impending danger","volume":"23","author":"Villa","year":"2014","journal-title":"Int J Angiol"},{"key":"2025082722510832000_14.7.e242549.9","first-page":"1","article-title":"Arteriojejunal fistula presenting with recurrent obscure Gi hemorrhage in a patient with a failed pancreas allograft","volume":"2013","author":"Desai","year":"2013","journal-title":"Case Rep Transplant"},{"key":"2025082722510832000_14.7.e242549.10","doi-asserted-by":"crossref","first-page":"069","DOI":"10.23937\/2378-3397\/1410069","article-title":"Arterio-colonic fistula as a complication of failed pancreatic transplant","volume":"5","author":"Mantilla","year":"2018","journal-title":"Int J Surg Res Pract"},{"key":"2025082722510832000_14.7.e242549.11","doi-asserted-by":"crossref","first-page":"903,904","DOI":"10.1097\/00007890-199703270-00018","article-title":"Spontaneous arterioenteric fistula after pancreas transplantation","volume":"63","author":"Gritsch","year":"1997","journal-title":"Transplantation"},{"key":"2025082722510832000_14.7.e242549.12","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1177\/000313480407000614","article-title":"Atypical etiology of massive gastrointestinal bleeding: arterio-enteric fistula following enteric drained pancreas transplant","volume":"70","author":"Lopez","year":"2004","journal-title":"Am Surg"},{"key":"2025082722510832000_14.7.e242549.13","doi-asserted-by":"crossref","DOI":"10.1186\/1752-1947-4-357","article-title":"Volcano-like intermittent bleeding activity for seven years from an arterio-enteric fistula on a kidney graft site after pancreas-kidney transplantation: a case report","volume":"4","author":"H\u00e4rle","year":"2010","journal-title":"J Med Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-242549","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:51:20Z","timestamp":1756360280000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-242549"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":13,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,13]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2021-242549"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-242549","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}