Dergiler / Turkish Journal of Gastroenterology / 2003 / Cilt: 14 - Sayı: 4
Arterioportal fistula causing jejunal variceal hemorrhage
- Sayfa
- 266–269
- DOI
- —
Özet
Hepatoportal arteriovenöz fistüller, portal hipertansiyonun nadir nedenlerindendir ve ciddi gastrointestinal kanamalara yol açabilirler. Portal hipertansiyonda en önemli kanama kaynağı özofagus varisleridir. Bu olgu sunumunda 40 yaşında jejunal varis kanaması ile gelmiş olan bir hepatik arteriovenöz fistül vakası tartışılmıştır. Olgu, 4 yıl önce özofagus varis kanaması nedeniyle incelenirken, hepatoportal arteriovenöz fistül tanısı almıştı. Anjiografik balon uygulaması ile fistül kapatılmıştı. Dört yıl sonra gelişen jejunal varis kanaması medikal tedavi ile kontrol altına alındı. Cerrahi girişim istemeyen hasta izlemeye alındı.
Abstract
Hepatoportal arteriovenous fistulas are an uncommon cause of portal hypertension and may lead to severe gastrointestinal bleeding. Esophageal varices are the main source of hemorrhage in patients with portal hypertension. We report a 40-year-old man with a hepatic arterioportal fistula, who had gastrointestinal bleeding from jejunal varices. He had had hematemesis four years previously and was diagnosed as esophageal variceal bleeding secondary to hepatic arterioportal fistula-complicated portal hypertension. The fistula had been successfully closed with a detachable balloon but it was found to have reformed during his recent hospitalization for jejunal variceal bleeding. Alcoholism and development of portal vein thrombosis afterwards were the other contributing factors for jejunal variceal formation. Hemorrhage was controlled with medical treatment. Since he refused any surgical intervention he was discharged and advised to continue follow-up.