Iatrogenic arteriovenous fistula of the superior mesenteric vessels is rare, with only 22 cases being documented. We report herein a case of a 63-year-old man with an iatrogenic arteriovenous fistula which developed after a small bowel resection for intestinal tuberculosis. The patient was admitted to our hospital for a gastric ulcer, at which time an ultrasonogram demonstrated cystic dilatation of the superior mesenteric vein, proving to be an arteriovenous fistula of the mesenteric vessels. An angiogram of the superior mesenteric vessels subsequently confirmed this diagnosis and resection of the fistula was performed, followed by an uneventful recovery. Iatrogenic mesenteric arteriovenous fistula with no presenting symptoms, as in our case, is uncommon and surgery performed before the development of associated portal hypertension should achieve good results. A review of the literature follows the report of this case.
We herein describe a 48-year-old woman who developed a septum formation of the bile duct combined with an anomalous arrangement of the pancreaticobiliary ductal system in conjunction with gallbladder cancer. A preoperative endoscopic retrograde cholangiogram demonstrated a filling defect in the common hepatic duct which was misdiagnosed to be an elevated lesion. Further exploration revealed a septum formation of the bile duct along with gallbladder cancer. A resection of the dilated bile duct and gallbladder along with a dissection of the regional lymph nodes was performed. A histological evaluation showed the septum to consist of a normal bile duct wall while the tumor in the gallbladder was poorly differentiated adenocarcinoma. The patient made an uneventful recovery. The septum formation was presumed to be congenital in origin.
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