Primary Right External Iliac Artery to Small Bowel Fistula Treated with Endovascular Graft

An arterio-enteric fistula (AEF) is an aberrant connection between the gastrointestinal tract and an artery. This is a rare condition that can present with massive hematochezia that carries a high degree of morbidity and mortality. Classically, AEF are categorized in primary versus secondary. Primary AEF are typically a result of trauma, radiation, tumor invasion, or an atherosclerotic aneurysm. A secondary AEF develops as a repercussion of surgical intervention [2]. This is a case of primary arterio-enteric fistula in a 65-year-old female with bladder cancer who had undergone chemoradiotherapy.