Portopulmonary Hypertension: A Complex Case Derived from Multiple Penetrating Trauma-Induced Mesenteric Arteriovenous Fistulae.

• 影响指数: 1.607
• 发表时间: Jul 2019
• 来源期刊: Ann Vasc Surg
• DOI: 10.1016/j.avsg.2018.12.078
• PMID: 30802581
• 文章类型: Case Reports
• 中科院分区: Q4
• 方向: 医学
• 作者列表: Qian K,Yang N,Lin C,Wan H,Fu F,Liu Z,Lin Z,Liu H

Mesh: Abdominal Injuries / diagnosis etiology; Adult; Angiography, Digital Subtraction; Arterial Pressure; Arteriovenous Fistula / diagnostic imaging etiology physiopathology surgery; Computed Tomography Angiography; Humans; Hypertension, Portal / diagnostic imaging etiology physiopathology surgery; Hypertension, Pulmonary / diagnostic imaging etiology physiopathology surgery; Male; Mesenteric Arteries / diagnostic imaging injuries physiopathology surgery; Mesenteric Veins / diagnostic imaging injuries physiopathology surgery; Multiple Trauma / diagnosis etiology; Phlebography / methods; Portal Pressure; Pulmonary Artery / physiopathology; Wounds, Stab / diagnosis etiology

Abstract

Portopulmonary hypertension (PoPH) is a well-recognized complication of portal hypertension. This study reports a case of PoPH that was secondarily caused by post-traumatic mesenteric arteriovenous fistula. A 38-year-old man with a history of knife stabbing wounds in the abdomen in 2003 was admitted to the hospital with exertional shortness of breath and a mechanic murmur over the umbilical region. Computed tomography indicated signs of PoPH and mesenteric arteriovenous fistula. Percutaneous catheter-directed embolization was first performed but failed. Subsequently, the patient was successfully treated with fistula resection and partial enterectomy. The patient had been postoperatively followed regularly, and chief symptoms had been alleviated significantly and pulmonary pressure had successfully decreased to normal range. We believe that this is the first case of PoPH caused by mesenteric arteriovenous fistula.