Lee Seunghun, Chung Jooweon, Ahn Byungkwon, Lee Seunghyun, Baek Sunguhn
Division of Colorectal Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.
Ann Surg Treat Res. 2017 Oct;93(4):225-228. doi: 10.4174/astr.2017.93.4.225. Epub 2017 Sep 28.
Arteriovenous fistula (AVF) involving the inferior mesenteric artery and vein is very rare with only 33 cases described in the literature and may be of congenital or acquired (iatrogenic or traumatic) or idiopathic etiology. The pathophysiology of AVF that acts as a left-to-right shunt has accounted for clinical signs and symptoms associated with ischemic colitis, portal hypertension, and heart failure. A low incidence and nonspecific clinical signs and symptoms such as abdominal pain, thrill and mass, lower and upper gastrointestinal bleeding make it difficult to establish a diagnosis of inferior mesenteric AVF. Diagnosis of inferior mesenteric AVF is usually established by radiological or intraoperative examination. We report a case of idiopathic inferior mesenteric AVF causing ischemic colitis in a 56-year-old man that was diagnosed preoperatively by multidetector computed tomography and angiography and successfully treated by surgical resection.
累及肠系膜下动静脉的动静脉瘘（AVF）非常罕见，文献中仅描述了33例，其病因可能为先天性、后天性（医源性或创伤性）或特发性。作为左向右分流的AVF的病理生理学导致了与缺血性结肠炎、门静脉高压和心力衰竭相关的临床体征和症状。低发病率以及腹痛、震颤和肿块、上消化道和下消化道出血等非特异性临床体征和症状使得肠系膜下AVF的诊断变得困难。肠系膜下AVF的诊断通常通过影像学检查或术中检查来确立。我们报告一例56岁男性特发性肠系膜下AVF导致缺血性结肠炎的病例，该病例术前通过多排螺旋计算机断层扫描和血管造影得以诊断，并通过手术切除成功治疗。
