Biomaterial Database

Mesenteric arteriovenous fistula causing portal hypertension and bleeding duodenal varices. 1996

J Baranda, and J M Pontes, and F Portela, and L Silveira, and P Amaro, and P Ministro, and A Rosa, and I Pimenta, and P Andrade, and A Bernardes, and J Pereira, and M C Leitão, and A Donato, and D de Freitas

Department of Gastroenterology, Coimbra University Hospital, Portugal.

We report a case of portal hypertension associated with a non-traumatic arteriovenous fistula, presenting with bleeding duodenal varices. The patient was admitted for melaena. Emergency endoscopy showed oesophageal varices with no signs of recent bleeding and with no blood in the upper gastrointestinal tract. Arteriography of the coeliac axis and superior mesenteric artery failed to detect any bleeding source. Endoscopy was repeated because of persistent bleeding and revealed active bleeding from varices in the distal duodenum. The patient underwent surgery and a large paraduodenal varicose vein associated with an arteriovenous fistula was found. Resection of the paramural varix and surgical occlusion of the arteriovenous fistula were effective in the control of bleeding. Liver biopsy revealed mild portal fibrosis without cirrhosis. Three years after surgery the patient still has oesophageal varices but has not had recurrent bleeding. There was regression of intraduodenal varices.

UI	MeSH Term	Description	Entries
D006975	Hypertension, Portal	Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN.	Cruveilhier-Baumgarten Disease,Cruveilhier-Baumgarten Syndrome,Cruveilhier Baumgarten Disease,Cruveilhier Baumgarten Syndrome,Disease, Cruveilhier-Baumgarten,Portal Hypertension,Portal Hypertensions,Syndrome, Cruveilhier-Baumgarten
D008297	Male		Males
D008642	Mesenteric Veins	Veins which return blood from the intestines; the inferior mesenteric vein empties into the splenic vein, the superior mesenteric vein joins the splenic vein to form the portal vein.	Mesenteric Vein,Vein, Mesenteric,Veins, Mesenteric
D004386	Duodenum	The shortest and widest portion of the SMALL INTESTINE adjacent to the PYLORUS of the STOMACH. It is named for having the length equal to about the width of 12 fingers.	Duodenums
D006471	Gastrointestinal Hemorrhage	Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM.	Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D001164	Arteriovenous Fistula	An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE.	Aneurysm, Arteriovenous,Arteriovenous Aneurysm,Arteriovenous Fistulas,Fistula, Arteriovenous,Fistulas, Arteriovenous
D014648	Varicose Veins	Enlarged and tortuous VEINS.	Varices,Varix,Varicose Vein,Vein, Varicose,Veins, Varicose
D017537	Mesenteric Artery, Inferior	The artery supplying nearly all the left half of the transverse colon, the whole of the descending colon, the sigmoid colon, and the greater part of the rectum. It is smaller than the superior mesenteric artery (MESENTERIC ARTERY, SUPERIOR) and arises from the aorta above its bifurcation into the common iliac arteries.	Arteries, Inferior Mesenteric,Artery, Inferior Mesenteric,Inferior Mesenteric Arteries,Inferior Mesenteric Artery,Mesenteric Arteries, Inferior