November 1960

A Middle Colic Arteriovenous Fistula Developing as a Postgastrectomy Complication

Author Affiliations

Chief, Surgical Services, 7510th USAF Hospital, Wimpole Park, England.

Arch Surg. 1960;81(5):757-760. doi:10.1001/archsurg.1960.01300050079015

Numerous articles have been written discussing the complications which may develop following the performance of gastrectomy either for malignant disease or for medical failures in treatment of the peptic ulcer diathesis. In spite of this, the author could find no reported case in which a fistulous connection developed postoperatively between the middle colic artery and vein as a postgastrectomy sequela. Arteriovenous fistulas have been reported occurring following operative procedures in which the artery and veins may be ligated together such as amputations,13,20 hysterectomy,4 nephrectomy,6 splenectomy,2 and thyroidectomy.6 They have also been reported following penetrating trauma,1,3,17 ruptured abdominal aneurysms,3 surgery for herniated intervertebral disc,9,11 skeletal traction,7,8 and the rupture of a hepatic artery aneurysm into the portal vein.

The present report deals with a case in which a previous abdominal exploration in January of 1956 had confirmed the presence of a duodenal

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