Williams D B, Payne W S, Foulk W T, Johnson C M
Mayo Clin Proc. 1980 Jun;55(6):383-6.
A patient with an uncalcified splenic artery aneurysm with an arteriovenous fistula and aneurysmal dilatation of the splenic vein who underwent splenectomy and resection of the fistula is described. Splenic arteriovenous fistulas are rare and are usually associated with aneurysms of the splenic artery. Patients with these fistulas frequently have signs and symptoms of portal hypertension and may often present with upper gastrointestinal hemorrhage. The patient described in this report was asymptomatic, and the only manifestation of the fistula was a loud, continuous bruit in the left flank noted on routine physical examination. Although an upper abdominal incision can be used to manage most splenic artery aneurysms, a left thoracoabdominal incision is advocated in the presence of an arteriovenous fistula, particularly in anticipation of portal hypertension or aneurysm of the splenic vein.
本文描述了一名患有未钙化脾动脉瘤且伴有动静脉瘘和脾静脉瘤样扩张的患者，该患者接受了脾切除术及瘘管切除术。脾动静脉瘘较为罕见，通常与脾动脉的动脉瘤相关。患有这些瘘管的患者经常出现门静脉高压的体征和症状，且常以上消化道出血为表现。本报告中描述的患者无症状，瘘管的唯一表现是在常规体格检查时左侧腹部发现响亮、持续的杂音。虽然上腹部切口可用于处理大多数脾动脉瘤，但在存在动静脉瘘的情况下，尤其预期有门静脉高压或脾静脉瘤时，主张采用左胸腹联合切口。
