BackgroundIsolated iliac artery aneurysms are rare and difficult to diagnose. It is more common in males. It can be asymptomatic at diagnosis or can present with frank rupture, or symptoms caused by compression on nearby organs.Case presentationA 44 years old male was diagnosed with rectosigmoid adenocarcinoma and underwent low anterior resection. One year after the surgery, he presented with fistula between the rectal stump and left iliac artery that was managed by stenting.ConclusionA fistula between the rectal stump and the left iliac artery is very rare. There are several treatment options for ilio-rectal fistula but no conclusive specific treatment.

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