Abstract
A 77-year-old male presented at a local hospital with abdominal discomfort of 1-month duration. Three days earlier, he had undergone lower gastrointestinal endoscopy, a day after which, he developed fever and chills. A left internal iliac artery aneurysm of 11 cm in diameter and internal air were observed on an abdominal computed tomographic scan performed at the same hospital. Moderate melena was also confirmed. Based on these findings, infection of the left internal iliac artery aneurysm and rectal rupture was diagnosed, and emergency surgery was performed. The surgery, which involved a F-F (femoro-femoral) bypass followed by laparotomy and Hartmann's operation with excision of the aneurysm, saved the patient's life. In Japan, only few studies have reported cases of ilioenteric fistula in the lower gastrointestinal tract, and the onset of sepsis seen in this case was also rare. Thus, this case should be considered as a part of the differential diagnosis of sepsis and melena.
