[Arteriovenous lung fistula--diagnosis and surgical therapy]

Congenital pulmonary arteriovenous fistula is a rare condition and, for this reason, is repeatedly misinterpreted despite the typical complaints it gives rise to. On the basis of seven cases diagnosed and treated surgically by the present authors, including follow-up, the clinical picture is discussed in detail. The diagnosis of pulmonary arteriovenous fistula can be established on the basis of pulmonary antiography or, more simply, with the aid of digital subtraction angiography with representation of multiple fistulas and accurate localisation. Employing segmentectomy, it usually proves possible successfully to treat even multiple arteriovenous fistulas in the lung, and to achieve lasting freedom from symptoms and recurrent disease. Even if it is asymptomatic, pulmonary arteriovenous fistula should always be resected, since life-threatening ruptures with followed by bleeding into the parenchyma and haemothorax (as was observed in one of our patients) can occur.