Arteriovesical fistula as a complication of a gunshot wound to the pelvis: Treatment dilemma

The case is reported of an arteriovesical fistula after a gunshot wound to the pelvis in a 29-year-old man. It developed 20 days after an exploratory laparotomy with primary suture of the bladder. The patient presented with intermittent gross hematuria and diagnosis was made through cystoscopy and arteriogram. Treatment was initially performed through open embolization. Re-treatment with endovascular procedures was twice necessary. Further evolution led to complete recovery from symptoms after an open procedure. Virtually all forms of treatment were tried and the resolution was finally achieved after more than 7 months.