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Iatrogenic superior mesenteric arteriovenous fistula: Ultrasonographic, CT and angiographic features and histological findings of the liver biopsy
Author(s) -
IWAI MASAKI,
KASHIWADANI MOTOMU,
SUYAMA YOSHIKAZU,
MIYOSHI MASATO,
KASHIMA KEI
Publication year - 1990
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1990.tb01444.x
Subject(s) - medicine , radiology , superior mesenteric artery , fistula , mesenteric vein , arteriovenous fistula , superior mesenteric vein , abdomen , portal hypertension , biopsy , cirrhosis , portal vein
Iatrogenic superior mesenteric arteriovenous fistula is rare. We treated a patient with this problem 6 years after small bowel resection for intestinal obstruction. The symptoms and signs were those of intestinal ischaemia and portal hypertension with an abdominal bruit. Ultrasonography and enhanced computerized tomography of the abdomen suggested the presence of superior mesenteric arteriovenous fistula, with a dilated portal vein and a communication between the dilated superior mesenteric vein and its artery. The exact location of the fistula was then determined by selective superior mesenteric arteriography. The fistula was ligated in an emergency operation to prevent cardiac or renal failure and to relieve portal hypertension. Liver biopsy showed no cirrhotic changes, but fibrosis was seen around the portal veins. We describe here not only the diagnostic arteriographic findings of superior mesenteric arteriovenous fistula, but also the interesting and suggestive ultrasonographic and computed tomographic findings. Early correction of such fistulas is recommended to prevent cardiac or liver failure.