A 59-year-old woman presented to the emergency room with painless massive rectal bleeding, fever and syncope.
His personal history included squamous cell carcinoma of the cervix treated in 2004 (hysterectomy, double adnexectomy, radiotherapy and brachytherapy), squamous cell carcinoma of the tongue in 2005 and subsequent resection of the lung metastases.
On admission she was stable, with a hemoglobin of 7.8 g/dl and a hematocrit of 24%.
Abdominal X-ray and abdominal ultrasound were nonspecific.
Endoscopic studies showed abundant remnants in colon without identifying cause.
Abdominal CT showed a collection with gas at the level of the right psoas.
If there was persistence of rectorrhagia, the patient underwent surgery on the fourth day of admission, performing an emergency laparotomy in which a retrocecal inflammatory process affecting the iliac artery was found.
An extended right hemicolectomy and femoral-femoral bypass with saphenous vein were performed.
The patient was discharged 14 days after surgery.
Pathological anatomy revealed a right hemicolectomy specimen with mucosal necrosis and abundant blood material organized in the partially aedicular bed.
Targets of squamous cell carcinoma affecting serosa, fatty tissue and perineural and perivascular areas (large vessels)
Isolated lymph nodes without evidence of malignancy.
Endoarterial material with squamous cell groups.
