Department of Radiology, General Navy Hospital, 6# Fucheng Road, Beijing 100048, China.
World J Gastroenterol. 2010 May 14;16(18):2314-6. doi: 10.3748/wjg.v16.i18.2314.
Duodenocaval fistula (DCF) is an uncommon but lethal clinical entity. The high mortality has been attributed to the difficulty of diagnosis before attempts at definitive therapy. In this case report, we describe a patient with a series of computed tomography (CT) examinations over a 2-mo period in hospital. A low-density air bubble appeared in the inferior vena cava (IVC) on the second day in hospital and became clear on day 19, and gradually enlarged. Magnetic resonance imaging (MRI) also clearly demonstrated a high-signal enteric contrast medium or thrombus and signal-void air bubbles in the IVC. However, cavography did not show the filling defect. We suggest that noninvasive CT and MRI should be chosen as a first-line investigation, and IVC, including the surrounding structures, should be carefully reviewed on images if DCF is clinically considered.
十二指肠胃静脉瘘（DCF）是一种罕见但致命的临床病症。其高死亡率归因于在尝试确定性治疗之前诊断的难度。在本病例报告中，我们描述了一名患者在住院期间进行了一系列连续 2 个月的计算机断层扫描（CT）检查。患者于住院第二天出现下腔静脉（IVC）低密度气泡，19 日变得清晰，且逐渐增大。磁共振成像（MRI）也清晰地显示了 IVC 内高信号肠内对比剂或血栓和信号缺失的气泡。然而，腔静脉造影并未显示充盈缺损。我们建议，如果临床上考虑 DCF，则应选择非侵入性 CT 和 MRI 作为一线检查，并且应仔细检查 IVC 及其周围结构的图像。
