Stefanova Irena, Huddy Jeremy R, Richardson John
Department of Colorectal Surgery, Royal Surrey County Hospital, Guildford, UK.
J Surg Case Rep. 2020 Apr 30;2020(4):rjaa083. doi: 10.1093/jscr/rjaa083. eCollection 2020 Apr.
Visceral arteriovenous malformations (AVMs) are extremely rare with only a few cases described within the literature. To date, no cases of ischaemic colitis related to arteriovenous malformations affecting both superior and inferior mesenteric arteries have been reported. We report the first case of acute ischaemic colitis caused by venous congestion and reduced arterial flow due to combined AVMs in the territory of superior and inferior mesenteric arteries in a 51-year-old patient. After a multidisciplinary meeting, interventional radiology embolization was considered to be of unlikely benefit due to extensive varicosities; therefore, surgical treatment in the form of open subtotal colectomy and end ileostomy was performed. This case report demonstrates the severity and the complexity in the management of AVM-related ischaemic colitis, together with a review of the literature.
内脏动静脉畸形（AVM）极为罕见，文献中仅描述了少数病例。迄今为止，尚无关于影响肠系膜上动脉和肠系膜下动脉的动静脉畸形相关缺血性结肠炎的病例报道。我们报告了首例由一名51岁患者肠系膜上动脉和肠系膜下动脉区域的联合AVM导致静脉淤血和动脉血流减少引起的急性缺血性结肠炎病例。经过多学科会诊，由于广泛的静脉曲张，介入放射学栓塞被认为不太可能有益；因此，进行了开放式次全结肠切除术和末端回肠造口术形式的手术治疗。本病例报告展示了AVM相关缺血性结肠炎管理中的严重性和复杂性，并对文献进行了综述。
