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多层螺旋计算机断层扫描血管造影在诊断肠系膜上动脉静脉瘘合并肠系膜上静脉血栓形成中的作用:一例报告

Multidetector Computed Tomography Angiography Role in Diagnosing Superior Mesenteric Arteriovenous Fistula with Superior Mesenteric Vein Thrombosis: A Case Report.

作者信息

Satyam Satyam, Kose Snehal, Singh Sapna, Prakash Anjali, Garg Anju

机构信息

Department of Radiodiagnosis, Maulana Azad Medical College and Lok Nayak Hospital, Delhi, India.

出版信息

Euroasian J Hepatogastroenterol. 2022 Jul-Dec;12(2):98-101. doi: 10.5005/jp-journals-10018-1380.

Abstract

INTRODUCTION

Arteriovenous fistulas (AVF) of the superior mesenteric vasculature are rare vascular abnormalities. It often occurs due to iatrogenic injuries during bowel resection or abdominal traumas. As the patient exhibits a variety of signs and symptoms and can present late, diagnosis may be difficult.Multidetector computed tomography (MDCT) is the most common modality for imaging the small bowel, vessels, and mesentery in patients with mesenteric ischemia.

CASE PRESENTATION

We present the case of a 25-year-old man who presented with features of acute intestinal obstruction and was operated on in an emergency. Resection of gangrenous small bowel and bowel adhesiolysis with double barrel ileostomy was performed. During exploratory laparotomy, gangrenous bowels were found, but no cause of mesenteric ischemia could be delineated. Finally, on computed tomography angiography (CTA) superior mesenteric arteriovenous fistula (SMAVF) with superior mesenteric vein (SMV) thrombosis was diagnosed. The patient was advised of aggressive anticoagulant therapy.

CONCLUSION

Computed tomography angiography has become the most reliable diagnostic modality to confirm the diagnosis and guide the best treatment strategy.

HOW TO CITE THIS ARTICLE

Satyam S, Kose S, Singh S, . Multidetector Computed Tomography Angiography Role in Diagnosing Superior Mesenteric Arteriovenous Fistula with Superior Mesenteric Vein Thrombosis: A Case Report. Euroasian J Hepato-Gastroenterol 2022;12(2):98-101.

摘要

引言

肠系膜上血管动静脉瘘(AVF)是一种罕见的血管异常。它常因肠切除术中的医源性损伤或腹部外伤而发生。由于患者表现出多种体征和症状,且可能出现较晚,诊断可能具有挑战性。多排螺旋计算机断层扫描(MDCT)是肠系膜缺血患者小肠、血管和肠系膜成像的最常用方式。

病例介绍

我们报告一例25岁男性患者,其表现为急性肠梗阻症状并接受了急诊手术。进行了坏死小肠切除及双腔回肠造口术和肠粘连松解术。在剖腹探查术中发现了坏死肠段,但未明确肠系膜缺血的原因。最终,通过计算机断层扫描血管造影(CTA)诊断为肠系膜上动静脉瘘(SMAVF)伴肠系膜上静脉(SMV)血栓形成。建议患者接受积极的抗凝治疗。

结论

计算机断层扫描血管造影已成为确诊并指导最佳治疗策略的最可靠诊断方式。

如何引用本文

Satyam S, Kose S, Singh S, 。多排螺旋计算机断层扫描血管造影在诊断肠系膜上动静脉瘘伴肠系膜上静脉血栓形成中的作用:一例报告。《欧亚肝脏胃肠病学杂志》2022;12(2):98 - 101。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8627/10028700/81d9aff00c22/ejohg-12-98-g001.jpg

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