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Splenic arteriovenous fistula

T E Brothers1, J C Stanley, G B Zelenock

  • 1Department of Surgery, University of Michigan Medical Center, Ann Arbor, USA.

International Surgery
|April 1, 1995
PubMed
Summary
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Splenic arteriovenous fistulas can cause severe issues, often presenting as gastrointestinal bleeding or portal hypertension. Operative intervention remains the optimal management strategy for these rare vascular anomalies.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Radiology

Background:

  • Splenic arteriovenous fistulas (SAVFs) are rare vascular anomalies with significant morbidity.
  • Understanding their etiology, presentation, and management is crucial for patient outcomes.

Observation:

  • A comprehensive review of 91 patients with SAVFs was conducted.
  • Common causes include atherosclerotic aneurysm rupture (44%), congenital malformations (20%), and post-splenectomy (13%).

Findings:

  • Gastrointestinal hemorrhage (48%) and chronic portal hypertension (65%) were the most frequent manifestations.
  • Congenital fistulas and proximal locations were associated with higher rates of gastrointestinal hemorrhage (p < 0.05).
  • Management primarily involved splenectomy (70%) and fistula excision (59%), with operative intervention being optimal.

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Implications:

  • This review highlights the critical need for timely diagnosis and appropriate management of SAVFs.
  • Optimal treatment strategies focus on operative intervention, with percutaneous embolization as an adjunct in select cases.
  • Further research into less invasive treatment options may be warranted.