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Jenkins P, Dissanayake P, Riordan R. Systemic arteriopulmonary venous fistula (APVF): case presentation of an asymptomatic individual and a review of the literature. BMJ Case Rep 2021; 14:14/7/e241644. [PMID: 34326108 PMCID: PMC8323372 DOI: 10.1136/bcr-2021-241644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abnormal communications between the systemic and pulmonary venous systems are rare but can present as a opacity on chest radiograph. A solitary vessel communicating as a fistula directly between the systemic arterial circulation and the pulmonary venous system is not widely described. These may have significant implications in the long-term cardiovascular health of an individual acting as a left to right shunt. There is no clear consensus as to the management, but surgical management and endovascular embolisation have been successfully used. We present a case where a systemic arteriaopulmonary fistula originating from the abdominal aorta and connecting to the right inferior pulmonary vein manifested as an incidental finding on a chest radiograph and was further evaluated on cross-sectional imaging in a young patient. Chest radiographs are non-specific and it is important to be aware of the less frequent but important pathologies that can be picked up on plain chest radiographs, which inturn should warrant further investigation. This is presented in conjunction with a review of the available literature along with a discussion regarding the differential diagnosis and management applicable to the general clinician.
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Affiliation(s)
- Paul Jenkins
- Radiology, Peninsula Radiology Academy, Plymouth, UK
| | | | - Richard Riordan
- Radiology, University Hospitals Plymouth NHS Trust, Plymouth, Plymouth, UK
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Hsueh CH, Wu CJ, Wu TH, Chou YP, Lin HL. Descending aorta to right pulmonary artery fistula. J Card Surg 2019; 34:43-44. [PMID: 30625258 DOI: 10.1111/jocs.13973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Chun-Hung Hsueh
- Division of Cardiovascular Surgery, Department of Surgery, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan.,Department of Critical Care Medicine, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan.,Department of Surgery, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan
| | - Chieh-Jen Wu
- Division of Cardiovascular Surgery, Department of Surgery, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan
| | - Tung-Ho Wu
- Division of Cardiovascular Surgery, Department of Surgery, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan.,Department of Critical Care Medicine, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan.,Department of Surgery, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan
| | - Yi-Pin Chou
- Division of Thoracic Surgery, Department of Surgery, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan.,Division of Trauma, Department of Emergency, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan
| | - Hsing-Lin Lin
- Department of Critical Care Medicine, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan.,Department of Surgery, Veterans General Hospital- Kaohsiung, Kaohsiung, Taiwan
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