Spontaneous inferior mesenteric arteriovenous fistula as a cause of severe portal hypertension and cardiomyopathy

Jaideep Das Gupta, MD; Muhammad A. Rana, MD; Adam Delu, MD; Sundeep Guliani, MD; Mark Langsfeld, MD; John Marek, MD

Journal of Vascular Surgery Cases and Innovative Techniques (Jun 2019)

Spontaneous inferior mesenteric arteriovenous fistula as a cause of severe portal hypertension and cardiomyopathy

Jaideep Das Gupta, MD,
Muhammad A. Rana, MD,
Adam Delu, MD,
Sundeep Guliani, MD,
Mark Langsfeld, MD,
John Marek, MD

Affiliations

Jaideep Das Gupta, MD: Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM
Muhammad A. Rana, MD: Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM; Division of Vascular Surgery, University of New Mexico School of Medicine, Albuquerque, NM; Correspondence: Muhammad A. Rana, MD, University of New Mexico, MSC 10 5610, 1, Albuquerque, NM 87131
Adam Delu, MD: Department of Radiology, University of New Mexico School of Medicine, Albuquerque, NM
Sundeep Guliani, MD: Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM; Division of Vascular Surgery, University of New Mexico School of Medicine, Albuquerque, NM
Mark Langsfeld, MD: Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM; Division of Vascular Surgery, University of New Mexico School of Medicine, Albuquerque, NM
John Marek, MD: Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM; Division of Vascular Surgery, University of New Mexico School of Medicine, Albuquerque, NM

Journal volume & issue: Vol. 5, no. 2
pp. 113 – 116

Abstract

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Inferior mesenteric artery (IMA) and inferior mesenteric vein (IMV) fistulas or malformations are extremely rare, with only 36 cases reported. Low incidence and nonspecific clinical signs and symptoms make mesenteric arteriovenous fistulas difficult to diagnose. We describe a case of a primary IMA-IMV fistula. Our patient presented with severe portal hypertension and cardiomyopathy along with robust arteriovenous connections between the IMA and IMV. Arterial embolization in this patient had to be followed by venous embolization for successful resolution of portal hypertension and cardiomyopathy. This case also highlights that close outpatient monitoring for treatment failure and recurrence is necessary for this disease process. Keywords: Inferior mesenteric artery, Inferior mesenteric vein, Arteriovenous fistula and malformation, Amplatzer, Embolization, Portal hypertension

Published in Journal of Vascular Surgery Cases and Innovative Techniques

ISSN: 2468-4287 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/journal-of-vascular-surgery-cases-innovations-and-techniques

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