Karna Rahul, Jagdish Balaji, Mohy-Ud-Din Nabeeha, Kulkarni Abhijit
Department of Medicine, Allegheny General Hospital, Pittsburgh, PA.
Division of Gastroenterology and Hepatology, Allegheny General Hospital, Pittsburgh, PA.
ACG Case Rep J. 2023 Aug 31;10(9):e01132. doi: 10.14309/crj.0000000000001132. eCollection 2023 Sep.
An arteriovenous-enteric fistula is a 3-way connection between the vascular and enteric system and associated with high mortality. We describe a case of iliac artery-inferior vena cava-duodenal fistula in a young female with a retroperitoneal mass presenting with sepsis and hemorrhagic shock with a catastrophic clinical course. These fistulas can be missed on endoscopy/colonoscopy and are usually diagnosed on computed tomography angiogram of the abdomen. Complex vasculoenteric fistula should be among differentials in patients presenting with gastrointestinal bleeding, especially with a history of malignancy, radiation, foreign bodies, and trauma. The management is complex and should involve a multidisciplinary approach involving vascular surgery, intervention radiology, and gastroenterologist.
动静脉-肠瘘是血管系统和肠道系统之间的一种三通连接，与高死亡率相关。我们描述了一例年轻女性的髂动脉-下腔静脉-十二指肠瘘，该患者有腹膜后肿块，表现为脓毒症和失血性休克，临床过程凶险。这些瘘在内镜检查/结肠镜检查时可能漏诊，通常通过腹部计算机断层血管造影来诊断。复杂的血管-肠瘘应列入出现胃肠道出血患者的鉴别诊断范围，尤其是有恶性肿瘤、放疗、异物和外伤史的患者。其治疗很复杂，应采用多学科方法，包括血管外科、介入放射学和胃肠病学专家。
