Spinal Venous Vascular Ectasia With Unusual presentation of Abdominal Pain: Case Report

Abstract

BACKGROUND AND IMPORTANCE: Spinal venous vascular ectasia associated with a low-flow fistula of paravertebral location is a very low-frequency entity. It usually manifests with myelopathy; however, in the present case, the symptomatology corresponded to thoracic radiculopathy, which can be difficult to diagnose and may be the cause of chronic pain refractory to analgesic management. CLINICAL PRESENTATION: An adult patient who consulted about a 1 year and a half of flank pain refractory to analgesic management and hypoesthesia on palpation in the left T8 dermatome, therefore, pain of radicular origin was suspected. MRI of the thoracic spine was requested, showing an image suggestive of vascular malformation at the level of T8. After identification of the lesion, the patient was taken to spinal angiography to delimit the vascular malformation, finding an image suggestive of spinal venous vascular ectasia associated with a low-flow fistula of paravertebral location at T8. Subsequently, the case was discussed by a multidisciplinary team that established endovascular embolization as the best option for treatment. Thus, achieving complete occlusion of the lesion without complications and a slow improvement of the symptoms. CONCLUSION: Spinal venous vascular ectasia associated with a low-flow fistula of paravertebral location is a very low-frequency entity that despite manifesting with myelopathy in some cases may generate radicular irritative symptoms and is differentiated from other lesions by its unusual location in spinal angiography.