Lower Gastrointestinal Bleeding from Aneurysmo-Colonic Fistula after Endovascular Aneurysm Repair

We report a rare case of internal iliac artery aneurysmo-colonic fistula that developed after endovascular aneurysm repair (EVAR) and transarterial embolization (TAE) in the distal internal iliac artery. An 81-year-old man with a history of internal iliac artery aneurysm (IIAA) received TAE and EVAR. He developed hydronephrosis 7 months after the operation, so he received a percutaneous nephrostomy (PCN). Thereafter, he developed hematuria persisting for more than 2 years. Moreover, hematochezia occurred 2 years after the hematuria episode. Owing to the internal iliac artery aneurysmo-colonic fistula, hematochezia developed subsequently.