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[Arteriovenous fistula of the cecum diagnosed by digital angiography]
Insights
Digital angiography accurately diagnosed arteriovenous malformations causing gastrointestinal bleeding in a hemodialysis patient. This imaging technique is recommended for unexplained bleeding, especially in patients with chronic renal failure and hemodialysis.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Nephrology
Background:
- Gastrointestinal hemorrhage (GIH) can be challenging to diagnose using conventional methods.
- Patients with chronic renal failure (CRF) on hemodialysis present unique diagnostic and management complexities.
- Arteriovenous malformations (AVMs) are a potential, though less common, cause of GIH.
Abstract:
We report the case of a 69 year-old female, with cardiac disease, hypertension, and chronic renal failure treated by hemodialysis; she had several episodes of gastrointestinal hemorrhage, which could not be diagnosed by conventional methods. Digital angiographic study demonstrated the exact cause: it allowed to localize an arterio-venous malformation. A right hemicolectomy was performed and the pathologic study showed the presence of an arteriovenous fistula. Three years later the patient is free of symptoms. We recommend digital angiography in cases of gastrointestinal hemorrhage of unknown or unclear etiology, particularly in patients in chronic renal failure, on the basis of the association of hemodialysis and arteriovenous malformation.