Traumatic mesenteric arteriovenous fistula presenting as the superior mesenteric artery syndrome

Arteriovenous fistulas of the mesentery are rare sequelae of abdominal injuries or operations. Symptoms, when present, are most often due to intestinal ischemia or portal hypertension. Cardiac failure is less common, and the case described in this report is, to our knowledge, the first in which the patient presented with duodenal obstruction--the superior mesenteric artery syndrome. A bruit is an expected finding and a thrill is pathognomonic of an arteriovenous fistula. With rare exception, operation is indicated to dismantle the fistula.