[脾动静脉瘘]
[A splenic arteriovenous fistula].
作者信息
Macco Sven, van Werkum Michiel H, van Leersum Marc, Alvarez Herrero Lorenza, Roos Daphne
机构信息
Sint Antonius Ziekenhuis, Nieuwegein.
出版信息
Ned Tijdschr Geneeskd. 2014;158:A7342.
BACKGROUND
Splenic arteriovenous fistula is a rare entity which can present as portal hypertension and related symptoms.
CASE DESCRIPTION
A 60-year-old female attended the emergency department with haematemesis. She had microcytic anaemia and was admitted to the Gastroenterology and Hepatology Department. Gastroduodenoscopy revealed three grade II-III varices in the distal oesophagus. The ultrasound image was suggestive of liver cirrhosis and showed signs of portal hypertension such as ascites, splenomegaly and dilated vessels near the splenic hilum. CT angiography showed an enlarged splenic vein in the arterial phase suggestive of arteriovenous fistula. This was confirmed by selective angiography of the splenic artery. The splenic arteriovenous fistula was treated with percutaneous transarterial embolization.
CONCLUSION
Patients with an arteriovenous fistula in the spleen are generally treated by splenectomy. However, in our patient embolization treatment was effective.
背景
脾动静脉瘘是一种罕见的疾病，可表现为门静脉高压及相关症状。
病例描述
一名60岁女性因呕血就诊于急诊科。她患有小细胞贫血，被收入胃肠病学和肝病科。胃镜检查发现食管远端有三处II - III级静脉曲张。超声图像提示肝硬化，并显示出门静脉高压的征象，如腹水、脾肿大和脾门附近血管扩张。CT血管造影显示动脉期脾静脉增粗，提示存在动静脉瘘。脾动脉选择性血管造影证实了这一点。经皮经动脉栓塞术治疗脾动静脉瘘。
结论
脾脏动静脉瘘患者一般采用脾切除术治疗。然而，在我们的患者中，栓塞治疗是有效的。
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