Superior mesenteric arteriovenous fistula: A case report

A 57 year old man was hospitalized due to "dull pain and discomfort of upper abdomen for more than 2 months".In the past, due to the injury to the abdomen caused by a car accident in 2015, he underwent partial small bowel resection and colostomy.Physical examination on admission: yellow staining of skin and sclera, swelling of abdomen, surgical scar about 25 cm long can be seen in the right lower abdomen, and varicose veins in the abdominal wall.The abdomen is soft without tenderness.Enhanced CT of upper abdomen and CTV of portal vein showed liver cirrhosis, splenomegaly, portal hypertension and the formation of collateral circulation of esophagus gastric fundus and abdominal wall; Tumor like dilatation of superior mesenteric vein; Ascites formation.Interventional vascular surgery was performed.Inferior vena cava and Celiac Arteriography were performed to indicate superior mesenteric arteriovenous fistula (SMAVF) (Fig. A-G).Superior mesenteric arteriovenous fistula occlusion was performed, which Figure.Imaging findings (Contrast-enhanced CT, Portal vein CTV, Plain CT scan of abdomen and CTA of SMA after Interventional Embolization) (A, B): Arterial phase; (C, D): Portal phase; (E, F): Delayed phase; (G) Portal vein CTV; (H,I) Plain CT scan of abdomen after interventional embolization; (J) CTA of SMA after Interventional Embolization.