Case Report
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World J Gastroenterol. May 14, 2010; 16(18): 2314-2316
Published online May 14, 2010. doi: 10.3748/wjg.v16.i18.2314
Radiological diagnosis of duodenocaval fistula: A case report and literature review
Yong Guo, Yan-Qun Zhang, Wei Lin
Yong Guo, Yan-Qun Zhang, Wei Lin, Department of Radiology, General Navy Hospital, 6# Fucheng Road, Beijing 100048, China
Author contributions: Guo Y designed and performed the research, and wrote the paper; Zhang YQ and Lin W performed the research.
Correspondence to: Yong Guo, MD, Department of Radiology, General Navy Hospital, 6# Fucheng Road, Beijing 100048, China. guoyong27@hotmail.com
Telephone: +86-10-66958279 Fax: +86-10-68285793
Received: January 17, 2010
Revised: February 20, 2010
Accepted: February 27, 2010
Published online: May 14, 2010
Abstract

Duodenocaval fistula (DCF) is an uncommon but lethal clinical entity. The high mortality has been attributed to the difficulty of diagnosis before attempts at definitive therapy. In this case report, we describe a patient with a series of computed tomography (CT) examinations over a 2-mo period in hospital. A low-density air bubble appeared in the inferior vena cava (IVC) on the second day in hospital and became clear on day 19, and gradually enlarged. Magnetic resonance imaging (MRI) also clearly demonstrated a high-signal enteric contrast medium or thrombus and signal-void air bubbles in the IVC. However, cavography did not show the filling defect. We suggest that noninvasive CT and MRI should be chosen as a first-line investigation, and IVC, including the surrounding structures, should be carefully reviewed on images if DCF is clinically considered.

Keywords: Duodenocaval fistula; Computed tomography; Magnetic resonance imaging