以腹痛及消化道出血为首发症状的脾动静脉瘘1例报告

蔡媛媛; 吴仲文; 鹿娟

doi:10.3969/j.issn.1001-5256.2021.05.043

以腹痛及消化道出血为首发症状的脾动静脉瘘1例报告

DOI: 10.3969/j.issn.1001-5256.2021.05.043

1.
海南省中医院脾胃肝病科，海口 570203
2.
浙江大学医学院附属第一医院感染科，杭州 310000

基金项目:

国家卫生部中医肝病临床重点专科 (琼财社(2011)2435号)

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：蔡媛媛负责资料分析，撰写论文，收集数据；吴仲文负责拟定写作思路，指导撰写文章并最后定稿；鹿娟参与资料分析及收集数据。

详细信息

作者简介:
蔡媛媛(1984—)，女，副主任医师，主要从事肝胆及胃肠病的基础与临床研究

通信作者:
吴仲文, 电子信箱: wuzhongwenzju@163.com

中图分类号: R256.3
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- 被引次数: 0
出版历程
- 收稿日期: 2020-10-14
- 录用日期: 2020-11-13
- 出版日期: 2021-05-20

A case of splenic arteriovenous fistula with abdominal pain and gastrointestinal bleeding as the first symptoms

1.
Department of Spleen, Stomach and Liver Diseases, Hainan Provincial Hospital of Traditional Chinese Medicine, Haikou 570203, China
2.
Department of Infectious Diseases, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China

摘要

- 脾疾病 /
- 动静脉瘘 /
- 诊断，鉴别
- Splenic Diseases /
- Arteriovenous Fistula /
- Diagnosis, Differential

HTML全文

图 1 肝脏CTA检查结果(2018年2月1日)

注：a，脾动脉(细箭头)及动静脉瘘口(粗箭头)；b，脾静脉早显；c，明显增粗的脾静脉；d，脾动脉(细箭头)及脾静脉(粗箭头)同时显影；e~f，迂曲粗大的脾静脉以及瘘口(箭头)。

下载: 全尺寸图片幻灯片

图 2 DSA下介入治疗显影

注：a，迂曲粗大的脾静脉(箭头)；b，弹簧圈封堵后仅见脾动脉有小分支再显示脾静脉。

下载: 全尺寸图片幻灯片

参考文献(16)

[1]	DESHPANDE A, WOLFSON D, MADANICK RD. Clinical challenges and images in GI. Splenic arteriovenous fistula[J]. Gastroenterology, 2008, 135(1): 19, 329. DOI: 10.1053/j.gastro.2008.06.009.
[2]	LIU YY, DU P, BAO WX, et al. Diagnosis and treatment of splenic arteriovenous fistula after splenectomy[J]. Chin J Dig Surg, 2014, 13(12): 988-990. DOI: 10.3760/cma.j.issn.1673-9752.2014.12.018. 刘莹莹, 杜鹏, 包文霞, 等. 脾切除术后脾动静脉瘘的诊断与治疗[J]. 中华消化外科杂志, 2014, 13(12): 988-990. DOI: 10.3760/cma.j.issn.1673-9752.2014.12.018.
[3]	YE DC, LUO J, HUANG P. Portal hypertension caused by congenital intrasplenic arteriovenous fistula: A report of 2 cases[J]. Acta Acad Med Xinjiang, 1998, 21(3): 3-5. https://www.cnki.com.cn/Article/CJFDTOTAL-XJYY803.032.htm 叶德存, 罗军, 黄佩. 先天性脾内动静脉瘘引起的门脉高压症2例报告[J]. 新疆医学院学报, 1998, 21(3): 3-5. https://www.cnki.com.cn/Article/CJFDTOTAL-XJYY803.032.htm
[4]	DU YS, LI XY. Regional portal hypertension[J]. Clin Med, 2011, 31(8): 109-110. DOI: 10.3969/j.issn.1003-3548.2011.08.070. 杜永生, 李晓燕. 区域性门静脉高压症[J]. 临床医学, 2011, 31(8): 109-110. DOI: 10.3969/j.issn.1003-3548.2011.08.070.
[5]	MADSEN MA, FREVERT S, MADSEN PL, et al. Splenic arteriovenous fistula treated with percutaneous transarterial embolization[J]. Eur J Vasc Endovasc Surg, 2008, 36(5): 562-564. DOI: 10.1016/j.ejvs.2008.07.006.
[6]	KÖKLV S, YVKSEL O, ARHAN M, et al. Report of 24 left-sided portal hypertension cases: A single-center prospective cohort study[J]. Dig Dis Sci, 2005, 50(5): 976-982. DOI: 10.1007/s10620-005-2674-x.
[7]	PAN YM, XIE M, BAO SH, et al. The diagnosis and treatment of pancreatic segmental portal hypertension with upper gastrointestinal bleeding[J]. J Clin Hepatol, 2011, 27(11): 1184-1186. http://lcgdbzz.org/article/id/LCGD201111012 潘一明, 谢敏, 包善华, 等. 胰源性区域性门脉高压症合并上消化道出血的诊治分析[J]. 临床肝胆病杂志, 2011, 27(11): 1184-1186. http://lcgdbzz.org/article/id/LCGD201111012
[8]	WANG XD, SALVATORE JS. Endovascular diagnosis and therapy for traumatic arteriovenous fistulas: An analysis of 108 cases[J]. J Intervent Radiol, 2010, 19(7): 521-526. DOI: 10.3969/j.issn.1008-794X.2010.07.004. 王晓东, Salvatore JA Sclafani. 108例创伤性动静脉瘘的介入诊疗分析[J]. 介入放射学杂志, 2010, 19(7): 521-526. DOI: 10.3969/j.issn.1008-794X.2010.07.004.
[9]	ZHENG K, GUO X, FENG J, et al. Gastrointestinal bleeding due to pancreatic disease-related portal hypertension[J]. Gastroenterol Res Pract, 2020, 2020: 3825186. DOI: 10.1155/2020/3825186.
[10]	LUO ZW. A case of splenic arteriovenous fistula complicated with severe diarrhea[J]. Mod Digest Interv, 2020, 25(4): 3. DOI: 10.3969/j.issn.1672-2159.2020.04.035. 罗遵伟. 脾动静脉瘘并发严重腹泻1例[J]. 现代消化及介入诊疗, 2020, 25(4): 3. DOI: 10.3969/j.issn.1672-2159.2020.04.035.
[11]	HUANG B, WANG Q, XU LZ. Diagnosis and interventional treatment of splenic arteriovenous fistula after splenectomy: A case report[J]. Diagn Imag Interv Radiol, 2016, 25(3): 246-248. DOI: 10.3969/j.issn.1005-8001.2016.03.015. 黄波, 王奇, 徐良洲. 脾切除后脾动静脉瘘的诊断与介入治疗一例分析[J]. 影像诊断与介入放射学, 2016, 25(3): 246-248. DOI: 10.3969/j.issn.1005-8001.2016.03.015.
[12]	DENG FW, MA P, ZHAO C, et al. Doppler ultrasound diagnosis of asymptomatic splenic arteriovenous fistula: A case report[J]. Acad J Second Military Med Univ, 2002, 23(11): 1236. DOI: 10.3321/j.issn:0258-879X.2002.11.050. 邓凤威, 马萍, 赵彩, 等. 多普勒超声诊断无症状性脾动静脉瘘一例报告[J]. 第二军医大学学报, 2002, 23(11): 1236. DOI: 10.3321/j.issn:0258-879X.2002.11.050.
[13]	QIAN XJ, YANG XJ, ZHANG XW, et al. Imaging diagnosis and interventional treatment of traumatic splenic arteriovenous fistula: A case report[J/CD]. Chin J Vasc Surg(Electronic Edition), 2011, 3(1): 51-52. DOI: 10.3969/j.issn.1674-7429.2011.01.021. 钱学江, 杨效经, 张西伟, 等. 创伤性脾动静脉瘘的影像诊断与介入治疗一例[J/CD]. 中国血管外科杂志(电子版), 2011, 3(1): 51-52. DOI: 10.3969/j.issn.1674-7429.2011.01.021.
[14]	KELLER EJ, GHASEMIESFE A, SALEM R, et al. The role of four-dimensional flow mr imaging in the diagnosis and treatment of a splenic arteriovenous fistula[J]. J Vasc Interv Radiol, 2016, 27(11): 1736-1738. e1. DOI: 10.1016/j.jvir.2016.05.008.
[15]	SIABLIS D, PAPATHANASSIOU ZG, KARNABATIDIS D, et al. Splenic arteriovenous fistula and sudden onset of portal hypertension as complications of a ruptured splenic artery aneurysm: Successful treatment with transcatheter arterial embolization. A case study and review of the literature[J]. World J Gastroenterol, 2006, 12(26): 4264-4266. DOI: 10.3748/wjg.v12.i26.4264.
[16]	UEDA T, MURATA S, YAMAMOTO A, et al. Endovascular treatment of post-laparoscopic pancreatectomy splenic arteriovenous fistula with splenic vein aneurysm[J]. World J Gastroenterol, 2015, 21(25): 7907-7910. DOI: 10.3748/wjg.v21.i25.7907.