PMC5672656_01
A 73-year-old man with an arteriovenous malformation of the inferior mesenteric artery; abdominal ultrasound revealed a portal vein (white arrow) in the high limit of normality (15 mm).
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F1
Abdominal ultrasound revealed large volume abdominal ascites and portal vein in the high limit of normality [Figure 1].
A 73-year-old man with an arteriovenous malformation of the inferior mesenteric artery; (a) transversal computed tomography scan showed wall thickening of the descending colon (white arrow). (b) Coronal image (white arrow showed wall thickening of the descending colon).
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F2
CA-125. Computed tomography (CT) abdomen and pelvis with contrast showed wall thickening of the descending and sigmoid colon with edematous wall and extensive collateral formation in the inferior mesenteric artery (IMA) territory [Figure 2].
A 73-year-old man with an arteriovenous malformation of the inferior mesenteric artery; colonoscopy revealed edema in the left colon.
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F3
CT scan, but no mass lesions were seen endoscopically, and no biopsy was performed [Figure 3]. CT angiography of the abdomen and pelvis confirmed a large arterial malformation involving the IMA [Figure 4].
A 73-year-old man with an arteriovenous malformation of the inferior mesenteric artery; computed tomography angiography of the abdomen and pelvis confirmed a large arterial malformation involving the inferior mesenteric artery (white arrow). Gray arrows revealed abnormal vascularization.
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F4
CT scan, but no mass lesions were seen endoscopically, and no biopsy was performed [Figure 3]. CT angiography of the abdomen and pelvis confirmed a large arterial malformation involving the IMA [Figure 4].
A 73-year-old man with an arteriovenous malformation of the inferior mesenteric artery; arteriography; pre-embolization image (left) and post-embolization image (right). All branches of the inferior mesenteric artery are embolized with microcoils, from the splenic angle to the sigmoid branches, respecting the territory of the upper hemorrhoidal artery.
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F5
Subsequently, the patient underwent selective microcoil embolization of IMA branches supplying the splenic flexure, descending colon and sigmoid, selectively excluding the superior hemorrhoidal artery [Figure 5].
A 73-year-old man with an arteriovenous malformation of the inferior mesenteric artery; a large draining vein within the transverse mesocolon level was observed intraoperatively (white arrow).
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F6
A large draining vein within the transverse mesocolon level was observed [Figure 6].
A 73-year-old man with an arteriovenous malformation of the inferior mesenteric artery; resected colon specimen.
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F7
The pathological specimen revealed significant vascular proliferation and collateral formation within the mesentery and congestive changes in the mucosa secondary to a large AVM [Figure 7].