Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2008 Jul 14;14(26):4249-52.
doi: 10.3748/wjg.14.4249.

Ischemic colitis secondary to inferior mesenteric arteriovenous fistula and portal vein stenosis in a liver transplant recipient

In Hee Kim  1 , Dae Ghon Kim, Hyo Sung Kwak, Hee Chul Yu, Baik Hwan Cho, Ho Sung Park
Affiliations
Case Reports

Ischemic colitis secondary to inferior mesenteric arteriovenous fistula and portal vein stenosis in a liver transplant recipient

In Hee Kim et al. World J Gastroenterol. .

Abstract

Arteriovenous fistula (AVF) involving the inferior mesenteric vessels is rare, and the affected patients usually present with abdominal pain, mass, or features of established portal hypertension. Colonic ischemia is a less common and more serious manifestation of AVF. We report a case of ischemic colitis secondary to inferior mesenteric AVF in a patient who underwent a previous liver transplantation, subsequently developed portal vein stenosis, and then presented with acute lower gastrointestinal bleeding. He underwent percutaneous transhepatic placement of a portal vein stent and left colectomy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Colonoscopy revealing diffuse colonic ulceration, exudate, and hemorrhage in the sigmoid and descending colon.
Figure 2
Figure 2
Contrast-enhanced CT of the abdomen showing portal vein stenosis (white arrows) (A), an approximately 30 mm × 18 mm contrast-enhancing vascular mass (black arrows) (B), and an approximately 10 mm × 8 mm enhancing vascular structure before transplantation (black arrows) (C).
Figure 3
Figure 3
Angiography of the inferior mesenteric artery showing an AVF (arrow) with early opacification of a dilated vein.
Figure 4
Figure 4
Transhepatic portal venography showing portal vein stenosis (white arrow) with stasis in the mesenteric vein (A) and good patency of the portal vein following deployment of the metal stent (black arrows) (B).
Figure 5
Figure 5
Histopathologic examination of the resected sigmoid showing diffuse ischemic necrosis inflammatory infiltrations (HE × 20).
See this image and copyright information in PMC

References

    1. Van Way CW 3rd, Crane JM, Riddell DH, Foster JH. Arteriovenous fistula in the portal circulation. Surgery. 1971;70:876–890. - PubMed
    1. Capron JP, Gineston JL, Remond A, Lallement PY, Delamarre J, Revert R, Veyssier P. Inferior mesenteric arteriovenous fistula associated with portal hypertension and acute ischemic colitis. Successful occlusion by intraarterial embolization with steel coils. Gastroenterology. 1984;86:351–355. - PubMed
    1. Okada K, Furusyo N, Sawayama Y, Ishikawa N, Nabeshima S, Tsuchihashi T, Kashiwagi S, Hayashi J. Inferior mesenteric arteriovenous fistula eight years after sigmoidectomy. Intern Med. 2002;41:543–548. - PubMed
    1. Matsui A, Iwai K, Kawasaki R, Wada T, Mito Y, Doi T. [Transcatheter embolization of an inferior mesenteric arteriovenous fistula with frequent mucous diarrhea] Nippon Shokakibyo Gakkai Zasshi. 2007;104:194–199. - PubMed
    1. Baranda J, Pontes JM, Portela F, Silveira L, Amaro P, Ministro P, Rosa A, Pimenta I, Andrade P, Bernardes A, et al. Mesenteric arteriovenous fistula causing portal hypertension and bleeding duodenal varices. Eur J Gastroenterol Hepatol. 1996;8:1223–1225. - PubMed

Publication types