Successful Treatment of Ischemic Colitis Caused by an Arteriovenous Fistula in the Left Colic Artery by Transcatheter Arterial Embolization :A Case Report and Literature Review

We report a rare case of a patient with ischemic colitis caused by an arteriovenous fistula in the left colic artery that was managed by an interventional radiology (IVR) procedure. An 80-year-old man visited our hospital complaining of bloody stool. He had a past history of loop colostomy at the transverse colon because of radiation colitis after radiation therapy for prostate carcinoma. Colonoscopy at admission showed edematous and hemorrhagic mucosa in the descending colon, and we diagnosed ischemic colitis. Computed tomography and angiography of the inferior mesenteric artery revealed an arteriovenous fistula formation in the left colic artery, which we considered to be a possible cause of the ischemic colitis. After considering the patient's risks including many co-morbidities and an advanced age, we decided to treat the patient by transcatheter arterial embolization and managed his symptoms. In conclusion, transcatheter arterial embolization as an IVR procedure can be an effective treatment in selected patients. This procedure was successful in our patient, who had many co-morbidities and an advanced age.