Emergency transcatheter embolisation of superior mesenteric arteriovenous fistula complicated by recurrent haematemesis

Lau KY, Lo SWS, Sy NLA
Correspondence: Dr Sherwin SW Lo, sherwinlo@gmail.com

ABSTRACT
Arterioportal fistulas are rare. Superior mesenteric arteriovenous fistula is uncommon and usually observed in patients who have abdominal trauma or have undergone abdominal surgery. If untreated, mesenteric arteriovenous fistula is potentially fatal due to portal hypertension with potential complications such as massive variceal bleeding or progressive liver failure. We report a 50-year-old Chinese man who had a history of abdominal surgery and presented with recurrent haematemesis. He was diagnosed by multidetector computed tomography to have a superior mesenteric arteriovenous fistula. Subsequently, he presented with acute bleeding oesophageal varices. Emergency transarterial embolisation was successfully performed to arrest the bleeding.

Keywords: angiography, bleeding oesophageal varices, emergency transarterial embolisation, haematemesis, mesenteric arteriovenous fistula, multidetector computed tomography
Singapore Med J 2009; 50(1): e12-e15