David Robin, Trieu Judy A, Shokoohi Susanne
Department of Internal Medicine, Loyola University Medical Center, Maywood, IL.
Division of Nutrition and Gastroenterology, Loyola University Medical Center, Maywood, IL.
ACG Case Rep J. 2022 Jul 11;9(7):e00822. doi: 10.14309/crj.0000000000000822. eCollection 2022 Jul.
Arterio-enteric fistulas involving pancreas allograft are rare complications of transplantation that manifest as gastrointestinal bleeding. We discuss the case of a 34-year-old patient with failed pancreas transplant who presented with recurrent sentinel bleeding before catastrophic hemorrhage. Multiple endoscopies did not identify the source of bleeding, and subsequent angiography demonstrated a fistulous connection between the transplanted pancreatic artery and the small bowel. A stent graft was placed with immediate stabilization. We provide a review of the literature and discuss the clinical manifestations, diagnosis, and management of arterio-enteric fistulas to highlight the importance of early recognition and intervention in preventing life-threatening bleeding.
涉及胰腺移植的动脉-肠瘘是移植手术中罕见的并发症，表现为胃肠道出血。我们讨论了一名34岁胰腺移植失败患者的病例，该患者在发生灾难性出血前出现反复的哨兵样出血。多次内镜检查未发现出血源，随后血管造影显示移植的胰腺动脉与小肠之间存在瘘管连接。放置了覆膜支架后出血立即得到控制。我们回顾了文献，并讨论了动脉-肠瘘的临床表现、诊断和治疗，以强调早期识别和干预对预防危及生命的出血的重要性。
