Inferior mesenteric arteriovenous fistula with colonic ischemia: a case report and review of the literature
- Resource Type
- Authors
- Boris Guiu; A. Cubisino; Valentina Schembri
- Source
- Clinical journal of gastroenterology. 14(4)
- Subject
- Left colic artery
Male
medicine.medical_specialty
Abdominal pain
Arteriovenous fistula
Ischemic colitis
03 medical and health sciences
0302 clinical medicine
Mesenteric Veins
Ischemia
medicine.artery
medicine
Humans
Aged
business.industry
Gastroenterology
Sigmoid colon
Arteriovenous malformation
Mesenteric Artery, Inferior
General Medicine
medicine.disease
Surgery
medicine.anatomical_structure
030220 oncology & carcinogenesis
Arteriovenous Fistula
Portal hypertension
Inferior mesenteric vein
030211 gastroenterology & hepatology
medicine.symptom
business
Colitis, Ischemic
- Language
- ISSN
- 1865-7265
Inferior mesenteric arteriovenous fistula is a rare abnormal high flow communication with only 40 primary and secondary cases reported in literature. Shunting of arterial flow through the inferior mesenteric vein to the portal system can cause a variety of nonspecific clinical signs and symptoms usually associated with the diagnosis of arteriovenous malformation. Symptom intensities are flow-dependent and can range from minimal abdominal symptoms to severe heart failure due to left to right shunt. We report the case of a 72-year-old man without past history of abdominal surgery or trauma who was referred to our department for a 2-month history of intermittent diarrhea and abdominal pain caused by an arteriovenous fistula involving the left colic artery and the inferior mesenteric vein. A progressive and spontaneous improvement of symptoms and a control CT scan that confirmed the reduction of venous vascular engorgement and regression of parietal thickening of the left and sigmoid colon permitted a non-operative management.Inferior mesenteric arteriovenous fistula can be a rare cause of ischemic colitis and, if necessary, an appropriate treatment based on high clinical suspicion can reduce the risk of complications related to a missed diagnosis.