Successful Transcatheter Arterial Embolization Using N-Butyl-2-Cyanoacrylate as a Treatment for Refractory Inferior Epigastric Artery Pseudoaneurysm Accompanied by an Enterocutaneous Fistula: A Case Report

Inferior epigastric artery (IEA) pseudoaneurysms are well-known postoperative abdominal complications, which often require proper treatment. Treatment options include surgical ligation, transcatheter embolization, and thrombin injection. Here, we report a rare case of an IEA pseudoaneurysm, accompanied by a postsurgical enterocutaneous fistula. The pseudoaneurysm relapsed after transcatheter coil embolization and percutaneous thrombin injection; it was completely occluded by transcatheter arterial embolization using n-butyl-2-cyanoacrylate. The present case shows that a coexisting enterocutaneous fistula can affect the unresponsiveness of patients with IEA pseudoaneurysm to widely accepted treatments, such as coil embolization and thrombin injection, by creating an inflammatory environment. In such cases, repeated therapeutic trials may be required. Transcatheter arterial embolization using n-butyl-2-cyanoacrylate can be a feasible therapeutic option for patients with refractory IEA pseudoaneurysm, accompanied by an enterocutaneous fistula.