Duplex Doppler findings in splenic arteriovenous fistula

Piscaglia, Fabio; Valgimigli, Marco; Serra, Carla; Donati, Gabriele; Gramantieri, Laura; Bolondi, Luigi

doi:10.1002/(sici)1097-0096(199802)26:2<103::aid-jcu10>3.0.co;2-n

Cited by 12 publications

(8 citation statements)

References 4 publications

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“…Only 16% of cases presented without signs of portal hypertension 59. SAVF should be considered in a patient with signs of acute portal hypertension that is not associated with a chronic liver disease 57–63. Most cases are asymptomatic, but the clinical suspicion increases whenever a characteristic “machinery bruit” is auscultated in the epigastric, left upper quadrant or left flank area in 30% to 60% of cases 57,58.…”

Section: Splenic Arteriovenous Fistulamentioning

confidence: 99%

“…These symptoms are secondary to the hyperdynamic blood flow state through the arteriovenous shunt, which leads to the sudden increase in pressure and congestion within the portal and mesenteric venous system 57,58. Other clinical manifestations of SAVF are enumerated on Table 2 57–63. Untreated SAVF will eventually lead to portal hypertension and variceal bleeding, and intrahepatic sclerosis which causes irreversible portal hypertension that persists despite treatment 45,63…”

Section: Splenic Arteriovenous Fistulamentioning

confidence: 99%

“…Other clinical manifestations of SAVF are enumerated on Table 2 57–63. Untreated SAVF will eventually lead to portal hypertension and variceal bleeding, and intrahepatic sclerosis which causes irreversible portal hypertension that persists despite treatment 45,63…”

Section: Splenic Arteriovenous Fistulamentioning

confidence: 99%

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Vascular Diseases of the Spleen: A Review

Francisco

Trivedi

et al. 2017

Journal of Clinical and Translational Hepatology

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Vascular diseases of the spleen are relatively uncommon in the clinical practice. However, the reported incidence has been progressively increasing, probably due to advances in the imaging modalities used to detect them. This disease condition often presents with non-specific clinical manifestations, but can be associated with significant morbidity and mortality. This review article aims to provide updated clinical information on the different vascular diseases of the splenic vasculature—splenic vein thrombosis, splenic vein aneurysm, splenic artery aneurysm, splenic arteriovenous fistula, and spontaneous splenorenal shunt—in order to aid clinicians in early diagnosis and management.

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Section: Splenic Arteriovenous Fistulamentioning

confidence: 99%

Section: Splenic Arteriovenous Fistulamentioning

confidence: 99%

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Vascular Diseases of the Spleen: A Review

Francisco

Trivedi

et al. 2017

Journal of Clinical and Translational Hepatology

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“…Until recently, the standard technique for detecting a SAVF was coeliac or splenic arteriography. Now, however, ultrasonography or CT scanning can be used to establish the diagnosis 1 3–5 12. When a bruit is heard over the left flank, colour Doppler ultrasonography should first be performed to characterise the direction and velocity of blood flow.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic splenic arteriovenous fistula without splenic artery aneurysm

et al. 2015

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SUMMARYSplenic arteriovenous fistula (SAVF) without a splenic arterial aneurysm is a rare entity and may either be congenital or acquired. Acquired SAVFs are commonly due to adjacent splenic arterial aneurysm rupture, trauma or infection. We report a large idiopathic SAVF in a 50-year-old woman who had no symptoms. CT showed that the fistula was around the splenic hilum and no other specific findings. SAVF has a risk of sudden onset of portal hypertension and it should be treated as soon as diagnosed. Endovascular treatment for SAVF is now being performed successfully with increasing frequency, however, there is still no definitive evidence of treatment for SAVF. Treatment options should be determined appropriately depending on individual case characteristics and vascular anatomical variations. Our case was treated successfully with splenectomy, and long-term results are good without need of reintervention. BACKGROUND

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“…(1,4) Often difficult to diagnose clinically, SAVF may be suspected when a bruit is heard over the left flank; however, this is encountered in only 30% of cases. (4) SAVF may also be suspected when features of portal hypertension are evident in the absence of liver disease, (5) in patients with preexisting splenic artery aneurysms, and in patients with a history of surgery or trauma.…”

Section: Discussionmentioning

confidence: 99%