Abstract
A male patient with an arterio-portal fistula resulting from a mesenteric arteriovenous malformation, who developed portal hypertension and liver cirrhosis, is presented herein. The malformation was considered to be congenital in origin and its location made any ablative surgical procedure impossible. Such alternative treatments as ligation of the afferent arteries, followed by transarterial embolization were therefore given, but both were unsuccessful. We also present a review of the literatures of mesenteric arteriovenous fistula. Radical surgical approach for the rare entity is proposed. The case reported here as related to mesenteric arteriovenous communications of congenital origin is the seventh such case published, and the first which was ever found to be located in the trunk of the superior mesenteric artery.
Similar content being viewed by others
References
Van Way CZ, Crane JM, Riddell D, Foster JH. Arteriovenous fistulas. Surgery 1971; 70: 876–890.
Görlach G, Hagel KH, Mulch J, Scheld H, Hehlein F. Congenital arteriovenous fistula between the subclavian artery and the portal vein. J Cardiovascular Surg 1984; 25: 378–380.
Weigert VC. In die Milzvene geborstenes Aneurysma einer Milzarterie. Arch Path Anat (Virchos) 1886; 104: 26–30.
Anderson RD, Liebeskind A, Lowman RM, Arteriovenous fistula of the mesentery. Amer J Gastroenterology 1972; 57: 453–458.
Meyer CT, Troncale FG, Galloway S, Sheahan D. Arteriovenous malformations of the bowel. Medicine 1981; 60: 36–48.
Fulton RL, Wolfel DA. Hepatic artery-portal vein arteriovenous fistula; Report a case with notes on the pathophysiology of this condition. Arch Surg 1970; 100: 307–309.
Bredfeld JE, O Laughlin JC. Portal hypertension secondary to a congenital splenic arterioenous fistula. J Clin Gastroenterology 1980; 2: 355–358.
Puglionisi A, Giovanni V, Snider F, Camilli S, Cina G. A propos d’un cas de fistule artérioveineuse hépaticoportale. Problèmes de physiopathologie et clineque et revue de la littérature. J Chir 1980; 117: 607–619.
Pasternak BM, Cohen H. Arteriovenous fistula and forward hypertension in the portal circulation. Angiology 1978; 29: 367–373.
Sammoon BP, Neal MP, Armstrong RH, Hagee HG. Ten years experience with celiac and upper abdominal superior mesenteric arteriography. Am J Roentgenol 1967; 101: 345–360.
Movitz D, Finne B. Postoperative arteriovenous aneurysm in mesentery after small bowel resection. JAMA 1960; 173: 42–44.
Reams GB. A middle colic arteriovenous fistula developing as a postgastrectomy complication. Arch Surg 1960; 81: 756–760.
Munnel ER, Mots CR, Thompson WB. Iatrogenic arteriovenous fistula: Report of case involving the superior mesenteric vesscls. Amer Surg 1960; 26: 738–743.
Durham MW, Robnett AH, Harper HP, Yekel R. Arteriovenous fistula of the mesenteric vessels. West J Surg Obstet Gynec 1962; 70: 9–11.
Rabham NB, Guillebeau JG, Brachney EL. Arteriovenous fistula of the superior mesenteric vessels after a gunshot wound. New Eng J Med 1962; 266: 603–605.
Summer RG, Kistler PC, Mc Intosh HD. Recognition and surgical repair of superior mesenteric arteriovenous fistula. Circulation 1963; 7: 943–950.
Taylor RM, Douglas AP, Haking PM, Walder FC, Traumatic fistula between a main branch of the superior mesenteric artery and vein. Amer J Med 1965; 38: 641–645.
Currin JF, Metcalf BH. Postcolectomy arteriovenous fistula American J Gastroenterology 1966; 46: 352–355.
Grafe, WR, Steinberg I. Superior mesenteric arteriovenous fistula following small bowel resection. Gastroenterology 1965; 51: 231–235.
Van der Heyde MN, Vink M. A patient with an iatrogenous fistula in the territory of the portal vein. Arch Chir Neerl 1966; 18: 267–271.
Ganshirt LW, Weaver FE, Olander GA. Mesenteric arteriovenous fistula: Review of the literature and a report of a case. Vasc Surg 1967; 1: 82–85.
Spellman MW, Mandal A, Freeman HP, Massumi RA. Successful repair of an arteriovenous fistula between the superior mesenteric vessels secondary to a gunshot wound. Ann Surg 1967; 165: 458–463.
Forbes HW, Thompson CQ, Smith JW. Mesenteric arteriovenous fistula after gunshot wound. J Trauma 1969; 9: 806–811.
Varner JE, Oliver RI. Superior mesenteric arteriovenous fistula. Ann Surg 1969; 170: 862–865.
Warter J, Kieny R, Gillet B, Stoeck D, Hoffmann N, Haberer JP. Fistule artérioveineuse mésenterique aprés résection portielle de l’intestin grele. Ann Med Interne 1969; 120: 185–191.
Houdard C, Helenon C, Carles JF, Botella R, Favre M, Boulay MM, Boschet P. Fistule artérioveineuse mésentérique inferieure et rectocolite ulcéreuse. Arch Fr Mal App Dig 1970; 59: 463–474.
Smith RB, Stone H. Traumatic arteriovenous fistulas involving the portal venous system (case III). Amer J Surg 1970; 119: 570–573.
Tanenbaum B, Pochaczevsky R, Levowitz BS, Richter RM. Traumatic mesenteric arteriovenous fistula. Brit J Radiol 1970; 43: 726–729.
Metzfer DG hamilton RF, Stephenson DV. Mesenteric arteriovenous fistula. Unusual case of GI bleeding. Amer J Surg 1972; 124: 767–769.
Bole P, Andronaco JT, Purdy R. Superior mesenteric arteriovenous fistula secondary to a gunshot wound. J Cardivascular Surgery 1973; 14: 456–459.
Brunner JH, Stanley RJ. Superior mesenteric arteriovenous fistula. JAMA 1972; 223: 316–318.
Nicholas GG, Lane MF. Traumatic superior mesenteric artery superior mesenteric vein fistula. J Trauma 1974; 14: 344–347.
Paloyan D, Dollins PA, Washburn FP. Superior mesenteric arteriovenous fistula. Amer Surg 1974; 40: 481–484.
Matsumoto K, Murakami Y, Kimiichi U, Masunaga Y, Yasukochi H. A case of diffuse superior mesenteric arteriovenous malformation considered congenital in origin. Japanese Medical Radiology 1977; 37: 848–855.
Furukawa Y, Oizumi Y, Yamaguchi N, Taguchi M. One case of gastrointestinal bleeding caused by intestinal arteriovenous malformation. Nihon Hosshasen Gakkai Zasshi 1976; 36: 686, (abstract, in Japanese)
Wakabayashi T, Odagiri H, Eguchi T, Katayama K, Ogai T, Yanagida K. Arteriovenous fistula of the superior mesenteric vessels after bowel resection. J Med Soc Toho Japan 1977; 24: 292–297.
Sabatier JC, Burneton, JN, Drovillard J, Elie G, Tauernice J. Fistule artério-veineuse mésentérique inferieure de type congénital. A propos d’une observation. Revue de la littérature. J Radiol Electrol 1978; 59: 727–729.
Hirner A, Häring R, Bost H, Sörensen R. Die hyperkinetische portale hypertension. Die arterioportale fistel: Problematik, Kasuistik, literatur Ubersicht. Chirurg 1978; 49: 303–310.
Oyama K, Hayashi S, Kogure, T, Hirakawa K, Akaike A. Inferior mesenteric arteriovenous fistula. Report of a case and review of the literature. Nihon Igaku Hosshasen Gakkai Zasshi 1980; 40: 944–950. (in Japanese)
Capron JP, Gineston JL, Remond A, Lallement P, Delamarre J, Revert R, Veyssier P. Inferior mesenteric arteriovenous fistula associated with portal hypertension and acute ischemic colitis. Gastroenterology 1984; 86: 351–355.
Knox M, Chuang VP, Stewart MT, Superior mesenteric aneurysm and arteriovenous fistula: Angiographic and CT features. AJR 1985; 145: 383–384.
Johnston G, Gibson J. Portal hypertension resulting from splenic arteriovenous fistula. Gut 1965; 6: 500–502.
Vujic I, Meredith HC, Ameriks JA. Embolization for hepatoportal arteriovenous fistula. Am Surg 1980; 46: 366–370.
Gomes AS, Mali WP, Oppenheim WL. Embolization therapy in the management of congenital arteriovenous malformation. Radiology 1982; 144: 41–49.
Cooperman M, Martin EW, Evans W, Carey L. Use of doppler ultrasound in intraoperative localization of arteriovenous malformations. Am Surg 1979; 190: 24–26.
Margulis AF, Heinbecker P, Bernard HR. Operative mesenteric arteriography in the search for the site of bleeding in unexplained gastrointestinal hemorrhage. Surgery 1960; 48: 534–539.
Robertson HD, Gathright JB. The technique of intraoperative segmental artery arteriography to localize vascular ectasias. Dis Colon Rectum 1985; 28: 274–276.
Grannis FW, Foulk WT, Miller WE, Payne W. Diagnosis and management of an arteriovenous fistula of pancreas and duodenum. Mayo Clin Proc 1973; 48: 780–782.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Loria, L.E., Tsuchiya, R., Harada, N. et al. Congenital mesenteric arterio-portal fistula: Report of a case. The Japanese Journal of Surgery 18, 351–358 (1988). https://doi.org/10.1007/BF02471455
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02471455