Kato S, Nakagawa T, Kobayashi H, Arai E
Department of Surgery, Yukokai General Hospital, Osaka, Japan.
Surg Today. 1993;23(1):73-7. doi: 10.1007/BF00309004.
Iatrogenic arteriovenous fistula of the superior mesenteric vessels is rare, with only 22 cases being documented. We report herein a case of a 63-year-old man with an iatrogenic arteriovenous fistula which developed after a small bowel resection for intestinal tuberculosis. The patient was admitted to our hospital for a gastric ulcer, at which time an ultrasonogram demonstrated cystic dilatation of the superior mesenteric vein, proving to be an arteriovenous fistula of the mesenteric vessels. An angiogram of the superior mesenteric vessels subsequently confirmed this diagnosis and resection of the fistula was performed, followed by an uneventful recovery. Iatrogenic mesenteric arteriovenous fistula with no presenting symptoms, as in our case, is uncommon and surgery performed before the development of associated portal hypertension should achieve good results. A review of the literature follows the report of this case.
医源性肠系膜上血管动静脉瘘罕见,仅有22例文献记载。我们在此报告一例63岁男性医源性动静脉瘘病例,该瘘在因肠结核行小肠切除术后形成。患者因胃溃疡入院,当时超声检查显示肠系膜上静脉囊性扩张,证实为肠系膜血管动静脉瘘。随后肠系膜上血管造影证实了这一诊断,并对瘘进行了切除,患者恢复顺利。如我们的病例所示,无明显症状的医源性肠系膜动静脉瘘并不常见,在相关门静脉高压形成之前进行手术应能取得良好效果。本病例报告后附文献综述。