Korean J Gastroenterol.  2013 Nov;62(5):296-300. 10.4166/kjg.2013.62.5.296.

A Case of Traumatic Inferior Mesenteric Arteriovenous Fistula

• Jeon DO
• Park JS
• Kim JE
• Lee SJ
• Cho HJ
• Im SG
• Kim ID
• Han EM

• KMID: 1775738
• DOI: http://doi.org/10.4166/kjg.2013.62.5.296

Abstract

Inferior mesenteric arteriovenous fistula is rare and may be congenital or acquired. Affected patients present with abdominal pain, mass, or manifestations of portal hypertension and bowel ischemia. Until now, inferior mesenteric arteriovenous fistula due to trauma has not been reported. Herein, we report a case of a 53-year-old woman who had inferior mesenteric arteriovenous fistula considered to have originated from remote blunt trauma that was successfully treated by surgical resection of only the arteriovenous fistula without colectomy. To our knowledge, this is the first case of traumatic inferior mesenteric arteriovenous fistula.

Keyword

Inferior mesenteric artery; Arteriovenous fistula; Abdominal injuries

MeSH Terms

Arteriovenous Fistula/*diagnosis/pathology/surgery
Colonoscopy
Female
Humans
Mesenteric Artery, Inferior/radiography
Middle Aged
Tomography, X-Ray Computed
Treatment Outcome

Figure

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  Fig. 1. (A, B) Abdominal and pelvic CT. Mesenteric thickening producing a mass-like appearance is noted (white arrows).

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  Fig. 2. Colonoscopic findings. Diffuse mucosal edema with mild hyperemia is noted from mid rectum up to mid descending colon.

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  Fig. 3. Inferior mesenteric arteriogram. (A) Arterial phase shows multiple (about five) fine fistulous communications (white arrows) between left colic artery (LCA) proximal descending colon branch and inferior mesenteric vein (IMV). (B) Late arterial phase shows early opacification of IMV with multifocal narrowing (black arrow). (C, D) Venous phase shows retrograde filling of left colic vein (LCV), sigmoidal vein (SV), and superior rectal vein (SRV) and complete occlusion at proximal portion of IMV (black arrows).

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  Fig. 4. Gross finding. (A) Several segments of blood vessels with attached fat tissue are noted (measuring up to 11×2 cm). Microscopic pathologic findings (B, C) show thick walled vein with congestion (H&E stain; B, ×10; C, ×200).

Reference

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