Munechika Taro, Shiokawa Keiichi, Takeshita Issei, Shimokobe Hisaaki, Sahara Kurumi, Matsumoto Yoshiko, Aisu Naoya, Yoshimatsu Gumpei, Hasegawa Suguru
Department of Gastroenterological Surgery, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka City, Fukuoka, 814-0180, Japan.
Surg Case Rep. 2024 May 3;10(1):112. doi: 10.1186/s40792-024-01911-z.
Colonic varices are a rare gastrointestinal anomaly often associated with portal hypertension. Arteriovenous fistula (AVF) in the inferior mesenteric artery (IMA) region is even rarer. Diagnosis and treatment of these entities present unique challenges, especially when the IMA is involved.
A 48-year-old man with a history of cholecystectomy presented with after a positive fecal occult blood test. Investigations revealed varices from the splenic flexure to the transverse colon and suspected AVF in the IMA region. Given the high risk and low efficacy of endoscopic and radiological interventions, laparoscopic sigmoidectomy was performed. This surgical approach successfully addressed both the AVF and the associated varices.
This case underscores the importance of surgical intervention for AVF and colonic varices in the IMA region, particularly when other treatment options pose high risks and have limited efficacy. The favorable postoperative outcome in this case highlights the effectiveness of carefully chosen surgical methods when managing such complex and rare conditions.
结肠静脉曲张是一种罕见的胃肠道异常，常与门静脉高压相关。肠系膜下动脉（IMA）区域的动静脉瘘（AVF）更为罕见。这些病变的诊断和治疗具有独特的挑战性，尤其是当IMA受累时。
一名有胆囊切除术史的48岁男性在粪便潜血试验呈阳性后就诊。检查发现从脾曲到横结肠有静脉曲张，并怀疑IMA区域存在AVF。鉴于内镜和放射介入的高风险和低疗效，进行了腹腔镜乙状结肠切除术。这种手术方法成功解决了AVF和相关的静脉曲张。
该病例强调了IMA区域AVF和结肠静脉曲张手术干预的重要性，特别是当其他治疗选择风险高且疗效有限时。该病例良好的术后结果突出了在处理此类复杂罕见疾病时精心选择手术方法的有效性。
