title: Portal hypertension caused by postoperative superior mesenteric arteriovenous fistula.
abstract: BACKGROUND
  Arteriovenous fistula of the superior mesenteric blood vessels is a rare complicaton in abdominal surgery.
  
  
  METHODS
  We presented a 49-year-old man with cramp-like abdominal pain, abdominal distension and weight loss symptoms, with a history of previous small bowel resection and right colectomy, due to Crohn disease, 16 years ago. Clinical examination revealed a paraumbilical pulsation with systolic murmur and thrill. Ultrasonography and computed tomography revealed cystic dilatation of the superior mesenteric vein, hepatomegaly and ascites. Upper endoscopy revealed grade I esophageal varices with portal hypertensive gastropathy. The diagnosis of arteriovenous fistula between superior mesenteric artery and vein was confirmed by angiogram of the superior mesenteric vessels and resection of the fistula was performed. Control examination after nine months showed no signs of portal hypertension.
  
  
  CONCLUSIONS
  Early diagnosis and treatment of mesenteric blood vessel arteriovenous fistula prevents portal hypertension development and its complications.
authors: Clinic for Gastroenterology, Clinical Center of Serbia, Belgrade, Serbia. dr.popovic@ptt.rs
authors: Dusan Dj
authors: DDj
authors: Popović
authors: Milan
authors: M
authors: Spuran
authors: Lazar
authors: L
authors: Davidović
authors: Tamara
authors: T
authors: Alempijević
authors: Milenko
authors: M
authors: Ugljesić
authors: Igor
authors: I
authors: Banzić
authors: Dragica
authors: D
authors: Jadranin
authors: Nada
authors: N
authors: Kovacević
authors: Mirjana
authors: M
authors: Perisić
authors: Momcilo
authors: M
authors: Colić
authors: Miodrag
authors: M
authors: Krstić
mesh_terms: D001164:Arteriovenous Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology*; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography