Said H O, Tang J, Louis J F, Raffanel C, Godlewski G
Département de Chirurgie digestive et de Cancérologie digestive, hôpital Carémeau, Nîmes.
Chirurgie. 1994;120(6-7):385-7.
Among entero-vascular fistulae, the duodenocaval type is exceptional. A case arising in a patient operated 10 months ago from a right kidney cancer, is reported. The clinical feature associated a septicemia to an intestinal hemorrhage. The diagnosis of entero-vascular fistula was performed at the operating time. In the world literature only 8 cases of duodeno-caval fistulae have been previously reported. The injury of duodenocaval area is the most frequent etiology of the communication causing moderate digestive hemorrhage and understood septicemia. The imaging explorations may suspect the diagnosis that is confirmed baparotomy. The treatment is always a surgical one: closure of digestive fistula by intestinal patch and suture of vascular defect. The prognosis depends on experience and skill of the surgeon and remains serious.
在肠血管瘘中，十二指肠腔静脉型较为罕见。本文报道了一例10个月前因右肾癌接受手术的患者所发生的此类病例。临床特征为败血症合并肠道出血。肠血管瘘的诊断是在手术时做出的。在世界文献中，此前仅报道过8例十二指肠腔静脉瘘。十二指肠腔静脉区域的损伤是导致瘘管形成的最常见病因，可引起中度消化道出血并引发败血症。影像学检查可能会怀疑诊断，最终通过剖腹手术得以确诊。治疗通常采用手术方式：用肠补片封闭消化瘘，并缝合血管缺损处。预后取决于外科医生的经验和技术，情况依然严峻。
