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医源性肠系膜上动静脉瘘一例,该病例由中肠旋转不良手术引起。

A rare case of an iatrogenic superior mesenteric arteriovenous fistula following surgery for a midgut volvulus.

机构信息

Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

Ann R Coll Surg Engl. 2022 Feb;104(2):e37-e40. doi: 10.1308/rcsann.2021.0081. Epub 2021 Nov 22.

Abstract

Superior mesenteric arteriovenous fistula is an extremely rare vascular malformation with most cases occurring following abdominal trauma or surgery. They are often asymptomatic or present with various abdominal symptoms with or without features of portal hypertension. A 30-year-old man developed fistulising of the superior mesenteric artery into the superior mesenteric vein following bowel resection surgery for an acquired midgut volvulus. Although endovascular management remains the treatment of choice in such cases due to increased morbidity of a repeat abdominal surgery, definite risks remain, such as coil migration, which happened in this case. The open surgical approach remains the only option in such instances.

摘要

肠系膜上动静脉瘘是一种极其罕见的血管畸形,大多数情况下发生在腹部创伤或手术后。它们通常无症状,或表现为各种腹部症状,伴有或不伴有门脉高压的特征。一名 30 岁男性因获得性中肠旋转不良而行肠切除术,术后出现肠系膜上动脉瘘入肠系膜上静脉。尽管由于重复腹部手术的发病率增加,血管内治疗仍然是此类病例的首选治疗方法,但仍存在一定的风险,如本例中的线圈迁移。在这种情况下,开放手术仍然是唯一的选择。

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本文引用的文献

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Ann Vasc Surg. 1992 Jul;6(4):370-2. doi: 10.1007/BF02008795.

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