Spontaneous duodenal-caval fistula with embolization of intestinal contents.
We describe the second example of a duodenal-caval fistula in a patient with peptic ulcer disease. This condition was complicated by embolization of intestinal contents to the lung, with abundant intravascular mucin. This is the first histological documentation of intravascular mucin apart from amniotic fluid embolism. It is well known that mucin may activate coagulation. We propose that intravascular mucin activated the coagulation cascade in our patient, causing disseminated intravascular coagulation and adult respiratory distress syndrome.
Department of Laboratory Medicine, St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.
P V
PV
Cyr
H
H
Shuhaibar
J M
JM
Kay
D000328:Adult; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000473:pathology; D004211:Disseminated Intravascular Coagulation / Q000209:etiology / Q000473:pathology; D004378:Duodenal Diseases / Q000209:etiology* / Q000473:pathology; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology* / Q000473:pathology; D008297:Male; D009077:Mucins / Q000032:analysis; D010437:Peptic Ulcer / Q000150:complications* / Q000473:pathology; D011655:Pulmonary Embolism / Q000209:etiology* / Q000473:pathology; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000473:pathology; D014682:Vena Cava, Inferior
D009077:Mucins