Ann Surg Treat Res.  2017 Jun;92(6):440-443. 10.4174/astr.2017.92.6.440.

Colon perforation due to embolization coil for internal iliac aneurysm

• Lee HK
• Jung HS
• Chung SY
• Choi SJ

• KMID: 2387419
• DOI: http://doi.org/10.4174/astr.2017.92.6.440

Abstract

Coil migration is an extremely rare but hazardous complication of aneurysmal coil embolization. Only 1 case report has described coil migration following endovascular exclusion to gastrointestinal (GI) tract. We report the experience of a case of colon penetration caused by embolization coil placed for internal iliac aneurysm. A 66-year-old man visited the Emergency Department for hematochezia that had persisted for 3 months. Stent insertion and coil embolization of left internal iliac artery aneurysm had been performed on the patient 18 months ago. Colonoscopy was performed. It suggested penetration of sigmoid colon by embolization coil and diverticulum. Angiography revealed extravasation of contrast media at left internal iliac artery. Covered stent deployment was done in the left internal iliac artery. One week after the stent insertion, the patient underwent anterior resection, aneurysm resection, and coil removal. The patient recovered without complications. He was discharged at 2 weeks after the operation.

Keyword

Iliac aneurysm; Intestinal perforation; Endovascular procedure

MeSH Terms

Aged
Aneurysm
Angiography
Colon*
Colon, Sigmoid
Colonoscopy
Diverticulum
Embolization, Therapeutic
Emergency Service, Hospital
Endovascular Procedures
Extravasation of Diagnostic and Therapeutic Materials
Gastrointestinal Hemorrhage
Humans
Iliac Aneurysm*
Iliac Artery
Intestinal Perforation
Stents

Figure

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  Fig. 1 (A) On-table angiography show that aneurysm arising from left internal iliac artery. (B) Stent was deployed through left internal iliac artery and coiling embolization in left internal iliac aneurysm.

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  Fig. 2 Colonoscopy showed (A) sigmoid colon penetration of embolic coil and (B) diverticulum.

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  Fig. 3 (A) Angiography reveals extravasation of contrast medium from the left internal iliac artery and coil migration. (B) A self-expandable covered stent is sealing the leakage.

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  Fig. 4 Operation finding. (A) Embolization coil penetrating sigmoid colon across the left internal iliac aneurysm. (B) Removed colon and embolization coil.

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