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Mesenteric-Portal Fistula
Celiac Artery System Portal Vein Fistula

Presentation

Symptoms are generally nonspecific at presentation. Patients may present with abdominal pain, nausea, vomiting, or diarrhea. While rare, gastrointestinal bleeding, ascites, and mesenteric ischemia are some of the more alarming presentations [5]. [cureus.com]

The abdominal lump and bruit were still present but there was no ascites. The haemogram, renal and liver function tests were within normal limits. [ncbi.nlm.nih.gov]

Case Presentation A 75-year-old woman presented to an outside hospital with hematochezia and hematemesis. She had a surgical history of two small bowel resections four and six years prior to presentation. [cvirendovasc.springeropen.com]

We present an unusual case of a 34-year-old man presented with melena, initially thought to be secondary to bleeding varices from cirrhosis related to hepatitis B virus (HBV) infection. [scielo.isciii.es]

Aortoduodenal fistula after endovascular aneurysm repair presenting with aneurysm sac abscess. J Vasc Surg. 2009;50:919---20. [revistaangiologia.es]

Cardiovascular

  • Vascular Disease

    CT and MR Angiography: Comprehensive Vascular Assessment. Lippincott Williams & Wilkins. p. 318. ISBN 9781469801834. Archived from the original on 2017-09-08. ^ a b Gustavo S. Oderich (2014). Mesenteric Vascular Disease: Current Therapy. [en.wikipedia.org]

    In non GIT cause such as vascular disease or when the problem cannot be managed laparoscopically, laparotomy is indicated. [wjes.biomedcentral.com]

Workup

Through this case report, we hope to highlight awareness of this unusual condition, discuss the diagnostic workup and our management approach. [wjgnet.com]

Further workup revealed a large SMAVF as the cause of severe portal hypertension and gastroesophageal varices. Case Report A 34-year-old man presented with melena, without complaints of chronic abdominal pain. [scielo.isciii.es]

Serum

  • Transaminases Increased

    After successful embolisation, the serum transaminases increased [Table 1] and then gradually normalised. This probably happened due to a relative ischaemia secondary to the disruption of arterial blood flow through the portal vein. [ncbi.nlm.nih.gov]

Treatment

(April 06, 2021) Successful Coil Embolization Treatment of a Large Arterioportal Fistula: A Rare Cause of Mesenteric Ischemia. [cureus.com]

TY - JOUR T1 - Combined transhepatic portal venous and transarterial treatment of superior mesenteric arteriovenous fistula in a patient with cirrhosis. [unboundmedicine.com]

EVL as the preferred treatment was used in our patient. It created an opportunity for further treatment. [scielo.isciii.es]

Topics of parti- cular interest include feed-back regulation, new aspects of conservative and interventional treatment as well as modern surgical approaches including organ-preserving procedures. [books.google.com]

Therefore, a surgical treatment was considered to be the only suitable treatment for such severe ascites. Laparoscopic low anterior resection including APF in the mesorectum was performed using five ports. [sages.org]

Prognosis

Portal venous gas is often associated with a dismal prognosis, since it is related to extensive intestinal necrosis in 75% of all the cases [ 2 ]. [em-consulte.com]

Prognosis This depends on the prognosis of the underlying disease, and on the outcome of any complications such as variceal bleeding. [patient.info]

Gas in portal vein is a good predictive factor for diagnosis, management, and prognosis [ 56 ]. In the past the traditional teaching is to operate once you have radiological evidence of PVG. [wjes.biomedcentral.com]

Often, obviously dead segments are removed at the first operation, and a second-look operation is planned to assess segments that are borderline that may be savable after revascularization. [28] Prognosis [ edit ] The prognosis depends on prompt diagnosis [en.wikipedia.org]

The correct diagnosis and characterization of PVT is important for the prognosis and further treatment. [7] Portal vein tumor thrombosis (PVTT) is a poor prognostic indicator, which is found at diagnosis in 10-40% of patients with hepatocellular carcinoma [emedicine.medscape.com]

Etiology

Conclusions This report highlights a potential etiology of variceal bleeding in the acutely ill patient. [cvirendovasc.springeropen.com]

AVFs can occur as a result of blunt or penetrating traumas such as a gunshot or stab wound [ 1, 7 ] or idiopathic etiology [ 3, 4, 5 ]. [astr.or.kr]

This volume deals with all aspects of CHRONIC PANCREATITIS including epidemiology, etiology, morphology and pathophysiology, dia- gnostic imaging as well as conservative and operative treat- ment. [books.google.com]

Of the wide array of etiologies, mesenteric AVF is very rare, making this particular case of ischemic colitis caused by mesenteric AVF especially notable ( 3 ). [synapse.koreamed.org]

This fistula was of traumatic etiology and resulted in ongoing hemodynamically significant bleeding. [omicsonline.org]

Epidemiology

This volume deals with all aspects of CHRONIC PANCREATITIS including epidemiology, etiology, morphology and pathophysiology, dia- gnostic imaging as well as conservative and operative treat- ment. [books.google.com]

View Article Google Scholar Alqahtani S, Coffin CS, Burak K, Chen F, MacGregor J, Beck P: Hepatic portal venous gas: a report of two cases and a review of the epidemiology, pathogenesis, diagnosis and approach to management. [wjes.biomedcentral.com]

Pathophysiology

Detailed attention is paid to pathophysiology, clinical symptoms and findings, all relevant imaging modalities and other tests employed to evaluate abdominal injuries at the time of admission of the trauma victim. [books.google.de]

"Pathophysiology of Portal Hypertension and Esophageal Varices". International Journal of Hepatology. 2012 : 1–7. doi : 10.1155/2012/895787. PMC 3362051. [en.wikipedia.org]

This volume deals with all aspects of CHRONIC PANCREATITIS including epidemiology, etiology, morphology and pathophysiology, dia- gnostic imaging as well as conservative and operative treat- ment. [books.google.com]

The pathophysiologic, clinical and diagnostic aspects are explored in order to raise awareness of this rare condition. [ncbi.nlm.nih.gov]

Prevention

Endoscopic vein ligation - to prevent bleeding of oesophageal varices. [patient.info]

Prevention of recurrent bleeding Once the initial bleeding has ceased, measures are instigated to prevent recurrence. These include prophylactic banding or sclerotherapy and the use of pharmacological agents such as oral β-blockers. [surgwiki.com]

The presence of rapidly accumulating large volume ascites prevented pre-embolisation percutaneous transhepatic occlusion of the junction of the branch vein with the SMV. [ncbi.nlm.nih.gov]

In Asia it is routine to administer IV haptoglobin, which binds free hemoglobin, to prevent hemolysis-induced kidney damage. [radiologykey.com]

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