Recognition and Surgical Repair of Superior Mesenteric Arteriovenous Fistula

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Abstract
A patient is described with a traumatic arteriovenous shunt from the superior mesenteric artery to the superior mesenteric vein. The patient had no symptoms referable to this fistula 3 months after a gunshot wound to the abdomen. The diagnostic feature was a continuous bruit in the supraumbilical area. The radiographic technics used in determining the nature of this patient's fistula are described. This is the first reported case of a traumatic superior mesenteric arteriovenous fistula suspected clinically, demonstrated radiographically, and successfully repaired surgically. Although experience with such fistulas is limited, the fatal outcome of the only other case in the literature (not recognized ante mortem) indicates the need for careful auscultation over all abdominal surgical incisions and sites of trauma at regular intervals.