RESUMO
BACKGROUND: Superior mesenteric arteriovenous fistula (SMAVF) is a very rare disease and mainly manifests as abdominal pain, diarrhea, anorexia, and other portal hypertension symptoms. The diagnosis of the disease mainly relies on abdominal enhanced CT+3D reconstruction or digital subtraction angiography, and the treatment is mainly vascular interventional fistula occlusion. CASE SUMMARY: a 17-year-old female with a history of abdominal trauma and surgery was admitted to our hospital for diarrhea and abdominal distension. The patient was diagnosed with a superior mesenteric arteriovenous fistula after abdominal enhanced CT + 3D reconstruction. The patient was satisfied with the results after the superior mesenteric artery angiography + covered stent implantation. No discomfort symptoms occurred during the two-year follow-up. CONCLUSION: A history of abdominal trauma or surgery and clinical manifestations in combination with a radiological analysis are important indicators in the diagnosis of SMAVF. Interventional therapy is the preferred treatment.
RESUMO
BACKGROUND: There is no consensus regarding the relationship between HBV DNA and liver fibrosis, and the relationship between HBV DNA and the degree of liver cirrhosis has not been reported in patients with chronic HBV infection. METHODS: From January 2011 to December 2016, liver biopsies were performed on 396 patients with chronic hepatitis B and cirrhosis. Assessments of liver fibrosis and cirrhosis were based on the Laennec staging system. RESULTS: Serum levels of HBV DNA were correlated with fibrosis and cirrhosis (KW = 73.946, P<0.001). Serum HBV DNA level was correlated with mild fibrosis, moderate to severe fibrosis and cirrhosis (P = 0.009, P<0.001, and P<0.001, respectively). The HBeAg-positive group and HBeAg-negative group showed significant differences in HBV DNA levels, and the rates of mild fibrosis, severe fibrosis and cirrhosis were significantly different between these two groups (F = 17.585, P<0.001 and F = 6.017, P = 0.003, respectively). The replication status of the serum HBV DNA affected fibrosis formation as well as cirrhosis (χ2 = 53.76, P<0.001). In the HBeAg-positive group, the sensitivity, specificity and AUC values of HBV DNA as a predictor for mild fibrosis and cirrhosis were 64.3%, 78.94% and 0.818, respectively, and 81.0%, 69.2%, and 0.871, respectively. In the HBeAg-negative group, the sensitivity, specificity and AUC values of HBV DNA for liver sclerosis prediction were 48%, 76.8% and 0.697, respectively. CONCLUSIONS: Different HBV DNA levels had different effects on the formation of fibrosis and sclerosis in liver tissues. HBV DNA levels can predict mild fibrosis and cirrhosis in liver tissue, which is enhanced in HBeAg-positive patients.