Superior mesenteric arteriovenous fistula: Report of a case and review of the literature

Abstract

Iatrogenic arteriovenous fistula of the superior mesenteric vessels is rare, with only 22 cases being documented. We report herein a case of a 63-year-old man with an iatrogenic arteriovenous fistula which developed after a small bowel resection for intestinal tuberculosis. The patient was admitted to our hospital for a gastric ulcer, at which time an ultrasonogram demonstrated cystic dilatation of the superior mesenteric vein, proving to be an arteriovenous fistula of the mesenteric vessels. An angiogram of the superior mesenteric vessels subsequently confirmed this diagnosis and resection of the fistula was performed, followed by an uneventful recovery. Iatrogenic mesenteric arteriovenous fistula with no presenting symptoms, as in our case, is uncommon and surgery performed before the development of associated portal hypertension should achieve good results. A review of the literature follows the report of this case.

Post-traumatic superior mesenteric arteriovenous fistula: Endovascular treatment with a covered stent

“…3,4 Fistula may develop a few days to years after trauma owing to presumed, unrecognized injury to the superior mesenteric artery at initial presentation or operation. 1,5 Although many patients with this type of fistula remain asymptomatic, 6 most reported in the literature have a delayed presentation of weight loss, nausea, vomiting, abdominal pain, ascites, diarrhea, and signs of right heart failure such as pulmonary effusions, mesenteric ischemia, or bleeding. [7][8][9][10] The most consistent symptom is abdominal bruits that can be palpated in the periumbilical or epigastric region just left of the midline with systolic accentuation on auscultation.…”

Portal hypertension caused by postoperative superior mesenteric arteriovenous fistula

“…Clinical examination is performed to detect paraumbilical pulsation and systolic murms with thrill, such was in our patient. Abdominal ultrasonography and CT indicate the presence of AVF between AMS and VMS, with portal dilatation vein 3,21 . However, selective arteriography AMS, allows the determination of exact location and extensiveness of AVF.…”

“…Diarrhea is probably related to impaired perfusion of the mucosa 17 . Portal hypertension, congestive heart failure, or gastrointestinal tract hemorrhage have also been reported 14,15,[17][18][19][20][21] . In the presented patient, the first symptoms were abdominal dystension and cramp-like abdominal pain, as a result of portal hypertension.…”

Transcatheter coil embolization of an iatrogenic superior mesenteric arteriovenous fistula: Report of a case

“…1,3,4 Gastrointestinal symptoms such as abdominal pain or diarrhea may be due to either coexistent bowel disease or bowel ischemia because of the fi stula. 3 Our patient presented with abdominal pain and diarrhea; however, clinical evidence suggested no direct relationship between the abdominal pain and the fi stula.…”

“…If left untreated, serious complications such as portal hypertension, congestive heart failure, or gastrointestinal tract hemorrhage may occur. 1 We herein describe a case of an iatrogenic superior mesenteric AVF treated by transcatheter coil embolization, and review the current literature.…”