A CASE OF ARTERIOVENOUS MALFORMATION OF THE ILEUM

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  • 回腸動静脈奇形の1例

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Abstract

A 44-year-old man was admitted to the hospital because of massive anal bleeding 3 years before. Colonoscopy, upper gastrointestinal sereis, and gastroscopy failed to confirm any bleeding site, and the patient was followed up carefully. This time the patient was seen again at the hospital because of massive anal bleeding. No evident bleeding points were revealed by endoscopic examinations of the stomach and large intestine. But a blood flow from the ileocecal valve was noted and a leeding from the intestine was suspected. Abdominal CT revealed deep stained small intestine. Abdominal angiography and MRI angiography disclosed an abnormal deep stained intestine formed by a large superior mesenteric artery and two large veins which flowed back early. It was diagnosed as arteriovenous malformation. Laparotomy was carried out and an arteriovenous malformation of about 20cm in length at 15cm oral side from the ileum end was found. A partial excision of the ileum was performed, with a successful result.<br> In a review of the Japanese literature, 133 cases of arteriovenous malformation of he intestine have been seen. The arteriovenous malformation in this case is the biggest in diameters of both inflow artery and outflow vein and the size of the lesion among of them.

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