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Inferior mesenteric arteriovenous fistula with colonic ischemia: a case report and review of the literature

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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.

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Inferior mesenteric artery and vein


Arteriovenous fistula


Computed tomography


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We do not have any financial interest in the subject matter connected with our case report.

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AC and VS performed the literature review and wrote the manuscript. BG reviewed and edited the manuscript. All authors approved the submission.

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Correspondence to Antonio Cubisino.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Cubisino, A., Schembri, V. & Guiu, B. Inferior mesenteric arteriovenous fistula with colonic ischemia: a case report and review of the literature. Clin J Gastroenterol 14, 1131–1135 (2021).

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