{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:17:18Z","timestamp":1761092238520,"version":"build-2065373602"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A primary aortoenteric fistula (AEF) is a pathologic communication between the aorta and the gastrointestinal tract. Although uncommon, this condition carries a substantial risk of life-threatening hemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>An 82-year-old male with a history of coronary artery disease and chronic obstructive pulmonary disease (COPD) presented to the emergency department with acute gastrointestinal bleeding. Computed tomography (CT) revealed bilateral common iliac artery aneurysms and left internal iliac artery aneurysm. In addition, the rectal wall demonstrated heterogeneous thickening with an apparent focal discontinuity along the proximal left lateral wall, suggestive of a fistulous tract between the left internal iliac artery and the rectum. Emergency intervention was performed, which included embolization of the inflow and outflow tracts of the left internal iliac artery aneurysm using fibered coils, followed by deployment of a covered stent from the origin of the left common iliac artery to the left external iliac artery. The patient experienced recurrent gastrointestinal bleeding postoperatively, which was managed with endoscopic hemostasis. He was discharged on postoperative day 15 after the initial procedure and remained well during a 7-month follow-up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early and accurate diagnosis of aortoenteric fistula is paramount. Endovascular repair combined with endoscopic hemostasis can serve as an effective bridging or palliative strategy to stabilize patients and create a window for definitive surgery, despite this patient demonstrated a favorable short-term outcome.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1658009","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T04:12:34Z","timestamp":1761019954000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary internal Iliac Aneurysm-Rectal Fistula treated with a combined endovascular and endoscopic approach as a palliative strategy: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Tao","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongxingyu","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiyang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hankui","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1097\/00000658-198110000-00004","article-title":"Aortoenteric fistula","volume":"194","author":"Connolly","year":"1981","journal-title":"Ann Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"455.e17","DOI":"10.1016\/j.avsg.2019.07.016","article-title":"Emergent endovascular treatment in primary ilio-enteric Fistula","volume":"63","author":"Antunes","year":"2020","journal-title":"Ann Vasc Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1177\/15385744241257597","article-title":"Misdiagnosis of primary iliac aneurysmo-colonic Fistula as a submucosal tumor leading to delayed treatment: a case report","volume":"58","author":"Lee","year":"2024","journal-title":"Vasc Endovascular Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"518.e13","DOI":"10.1016\/j.avsg.2020.12.046","article-title":"Primary aortoduodenal Fistula: a case report and current literature review","volume":"74","author":"Georgeades","year":"2021","journal-title":"Ann Vasc Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.ejvs.2023.11.002","article-title":"Editor\u2019s choice \u2013 European society for vascular surgery (ESVS) 2024 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms","volume":"67","author":"Wanhainen","year":"2024","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e39159","DOI":"10.1097\/MD.0000000000039159","article-title":"Ruptured giant splenic artery aneurysm with an exceptional concurrent gastric and transverse colonic fistula: a rare case report","volume":"103","author":"Zain","year":"2024","journal-title":"Medicine (Baltimore)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"448.e9","DOI":"10.1016\/j.avsg.2020.05.018","article-title":"Successful endovascular repair of a ruptured common iliac artery aneurysm associated with an ileal pouch neobladder Fistula","volume":"69","author":"Tatsuishi","year":"2020","journal-title":"Ann Vasc Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e6966","DOI":"10.7759\/cureus.6966","article-title":"The herald bleed: a case report of an aortoenteric Fistula causing an acute lower gastrointestinal bleed","volume":"12","author":"Bhatti","year":"2020","journal-title":"Cureus"},{"key":"B9","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.ijscr.2017.08.063","article-title":"Case report: primary aortosigmoid fistula\u2014a rare cause of lower gastrointestinal bleeding","volume":"40","author":"Khalaf","year":"2017","journal-title":"Int J Surg Case Rep"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.3390\/medicina60071052","article-title":"An asymptomatic sigmoid colonic Fistula arising from a large aneurysm of the internal iliac artery was discovered during a medical examination","volume":"60","author":"Kim","year":"2024","journal-title":"Medicina (Kaunas)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"165","DOI":"10.6001\/actamedica.v23i3.3380","article-title":"Aorto-duodenal fistula: a rare but serious complication of gastrointestinal hemorrhage. 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