# Ischemic proctitis caused by a superior rectal arteriovenous fistula: a case report and literature review

## TL;DR

A rare case of ischemic proctitis caused by a superior rectal arteriovenous fistula is reported, highlighting the diagnostic and treatment challenges.

## Contribution

This case report adds to the limited literature on ischemic proctitis and its unusual vascular cause.

## Key findings

- A 61-year-old man presented with ischemic proctitis due to a superior rectal arteriovenous fistula.
- The patient required endoscopic hemostasis, embolization, and eventually proctectomy due to rectal stenosis.

## Abstract

Ischemic proctitis is a rare but severe condition characterized by ischemic injury to the rectum due to insufficient blood supply from the vessels feeding the rectum. Due to the rectum’s rich collateral circulation, ischemic proctitis is uncommon. We present a case of a 61-year-old man with ischemic proctitis presenting primarily with rectal bleeding. Angiography confirmed the presence of a superior rectal arteriovenous fistula. The diagnostic process was quite challenging. The patient underwent endoscopic hemostasis and interventional embolization, and eventually underwent proctectomy due to rectal stenosis. A literature review on ischemic proctitis is also included.