A Case of Intraabdominal Mesenteric Varice Rapture Due to Mesenteric ArterioVenous Malformation

Masahito Nawa, Juji Tsuchiya, Susumu Tachibana, Fumichika Kitamura, Iwao Kumazawa, Hajime Kawagoe and Koji Matsui

Department of Surgery, Ibi Kousei Hospital

A 38-year-old woman admitted for sudden lower abdominal pain with severe anemia was found in abdominal computed tomography (CT) to have retained large amounts of fluid in the abdominal cavity and to have markedly dilated mesocolon vessels. 3DCT angiography showed markedly dilated vessels in the left mesocolon, starting where the branch of the IMA intervened between the artery and varices in the pelvic cavity and entered the portal vein. Under a diagnosis of rupture of AVM or mesenteric varices, we conducted surgery. At laparatomy, we found severe bleeding from varices in the mesocolon, we stopped bleeding, ligating the mesocolon at the bleeding site with transfixing sutures. And we made transverse colostomy to prevent postoperative ischemic change or stenosis of the colon. Post operative angiography enhanced from SMA and iliac artery showed no AVM in the mesocolon. We assumed that a mesenteric varice was made due to blood flow from the AVM was flowed directly to the marginal vein of the left colon and eventually vaices was ruptured in the abdominal cavity.

Key words
mesenteric varice, arteriovenous malformation

Reprint requests
Masahito Nawa Department of Surgery, Ibi Kousei Hospital
2547-4 Miwa, Ibigawa-cho, Ibi-gun, 501-0619 JAPAN

Accepted
June 27, 2007

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