Abstract
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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Abbreviations
- IMA-V:
-
Inferior mesenteric artery and vein
- AVF:
-
Arteriovenous fistula
- CT:
-
Computed tomography
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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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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). https://doi.org/10.1007/s12328-021-01411-9
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DOI: https://doi.org/10.1007/s12328-021-01411-9