Ischemic Colitis Due to a Mesenteric Arteriovenous Malformation in a Patient with a Connective Tissue Disorder

Abstract

Ischemic colitis is a rare, life-threatening, consequence of mesenteric arteriovenous malformations. Ischemia ensues from a steal phenomenon through shunting, and may be compounded by the resulting portal hypertension. Computed tomographic angiography is the most common first-line test because it is quick, non-invasive, and allows for accurate anatomic characterization. Also, high-resolution three-dimensional images can be created for treatment planning. Magnetic resonance angiography is similarly sensitive for vascular mapping. Conventional angiography remains the gold standard for diagnosis and also allows for therapeutic endovascular embolization. Our patient underwent testing using all three of these modalities. We present the first reported case of this entity in a patient with a vascular connective tissue disorder.

Detection and Intervention of Clinically Masquerading Inferior Mesenteric Artery AVMs

“…Failure of undifferentiated embryonic vasculature regression is what leads to the typical imaging features of a dilated feeding artery, a nidus of tangled vessels and early draining veins [ 1 ]. Inferior mesenteric AVMs are typically accompanied by symptoms affiliated with portal hypertension such as ascites or variceal bleeding [ 2 – 4 ]. A smaller subset of patients display congestive ischemic colitis symptoms.…”