医源性髂动静脉瘘误诊为深静脉血栓1 例

髂动静脉瘘是后路腰椎间盘摘除术的一种罕见并发症，其表现与术后深静脉血栓形成引起的肺动脉血栓症状相似，临床上易导致误诊。笔者报告1例椎间盘切除术6个月后因腹胀、气促、左下肢浮肿等症状入院的51岁女性患者，初步被诊断为深静脉血栓，最终确诊为髂动静脉瘘。经植入带膜支架后成功地封闭了瘘口。随访半年，患者恢复情况良好。总结了髂动静脉瘘被误诊的经验教训，并讨论了该病与深静脉血栓形成引起的肺动脉血栓的鉴别诊断方法。

A case of iatrogenic ilio-iliac arteriovenous fistula initially misdiagnosed as deep venous thrombosis

Iliac arteriovenous fistula (AVF) usually manifests in a wide range of symptoms similar to typicaldeep venous thrombosis (DVT), which often lead to delayed diagnosis or misdiagnosis. Wereported a 51-year old woman who was performed lumbar discectomy and showed a progressiveabdominal distention, dyspnea, and swollen left leg. She was initially diagnosed as deep veinthrombosis and the final diagnosis was arteriovenous fistula. The fistula was successfully sealed byan endovascular covered stent. No further recurrence was found after a half year’s follow-up. Thisarticle summarized the experience regarding iliac arteriovenous fistula misdiagnosed, and discussedthe differential diagnosis between arteriovenous fistula and pulmonary thromboembolism causedby deep vein thrombosis.