Sreepriya P P, Kumar Anil, Paswan Shiv Shankar, Anand Utpal, Bharti Shreekant, Ranjan Rahul
Department of General Surgery, All India Institute of Medical Sciences, Patna, India.
Department of Trauma & Emergency (Gen Surgery), All India Institute of Medical Sciences, Patna, India.
Int J Surg Case Rep. 2022 Apr;93:106907. doi: 10.1016/j.ijscr.2022.106907. Epub 2022 Mar 2.
Visceral arteriovenous malformations (AVMs) are extremely rare with only a few cases described in the literature. We have encountered a mesenteric AVM in a 23-year-old girl. Considering the rarity of this entity and diagnostic dilemma, we herein describe a case of mesenteric AVM along with the review of literature.
A 23-year-old female presented with pain and lump in lower abdomen. During her workup to conclude a final diagnosis, Fine needle aspiration cytology (FNAC) was done. Post FNAC patient went into shock and immediately emergency laparotomy was done. The bleeding mass was resected along with involved gut and anastomosis was done. Histopathology suggested AVM. She was doing well at 2 months of follow up.
AVM is the rare cause of ischaemic colitis. It can create a diagnostic dilemma with its unusual presentation and its rarity even for both radiologists and surgeons. Usually such malformation reported after trauma or any surgical intervention, but in our case there was no such history of trauma which makes this case more interesting. Invasive investigation is recommended in such condition but needs to be very cautious. As in this index case invasive procedure lead to severe bleeding. Although definitive treatment are embolization and surgery.
Invasive procedure should be avoided in case of AVM. If angiography is not available its mandatory to keep operating room ready before any invasive procedure.
内脏动静脉畸形（AVM）极为罕见，文献中仅有少数病例报道。我们遇到一名23岁女孩患有肠系膜AVM。鉴于该病症的罕见性及诊断难题，我们在此描述一例肠系膜AVM病例并进行文献复习。
一名23岁女性因下腹部疼痛和肿块就诊。在进行最终诊断的检查过程中，进行了细针穿刺细胞学检查（FNAC）。FNAC检查后患者陷入休克，立即进行了急诊剖腹手术。切除了出血肿块及受累肠段并进行了吻合。组织病理学提示为AVM。随访2个月时她情况良好。
AVM是缺血性结肠炎的罕见病因。其不寻常的表现及罕见性给放射科医生和外科医生都带来了诊断难题。通常此类畸形在创伤或任何手术干预后才被报道，但我们的病例没有此类创伤史，这使得该病例更具趣味性。在这种情况下建议进行侵入性检查，但需非常谨慎。正如本病例，侵入性操作导致了严重出血。尽管确定性治疗方法是栓塞和手术。
对于AVM应避免进行侵入性操作。如果没有血管造影设备，在任何侵入性操作前必须准备好手术室。
