Unusual clinical course, Challenging differential diagnosis, Management of emergency care
Zunwei Luo, Ziyu Zhou
Department of Emergency, The Fourth People’s Hospital of Zunyi City, Zunyi, Guizhou, China (mainland)
Am J Case Rep 2020; 21:e922067
Available online: 2020-06-18
Splenic arteriovenous fistula is a relatively rare disease. Patients are often admitted to the hospital with gastrointestinal symptoms. It is easy to misdiagnose due to the difficulty of confirming diagnosis only by routine examination.
CASE REPORT: Our patient was critically ill, with an initial diagnosis of severe diarrhea with retroperitoneal hematoma before being referred to our hospital. Upon admission, the diagnosis of splenic arteriovenous fistula was made by computed tomography angiography. This patient with SAVF was successfully cured by distal splenic artery endovascular embolization therapy.
CONCLUSIONS: Clinicians should consider SAVF in the differential diagnosis of patients with severe diarrhea with uncommon causes. Endovascular embolization therapy needs to be considered vs. conventional surgical ligation by open surgery in terms of operation risks and outcomes, along with subsequent exploratory laparotomy.
Keywords: Arteriovenous Fistula, diarrhea, endovascular procedures, Hypertension, Portal, Splenectomy