A large congenital and solitary intrahepatic arterioportal fistula in an old woman |
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Authors: | Zhen-Ya Lu Jian-Yang Ao Tian-An Jiang Zhi-Yi Peng Zhan-Kun Wang |
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Affiliation: | 1. Department of Internal Medicine, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China 2. Department of Ultrasound,First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China 3. Department of Radiology, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China |
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Abstract: | Arterioportal fistula (APF) is a rare cause of portal hypertension and may lead to death. APF can be congenital, post-traumatic, iatrogenic (transhepatic intervention or biopsy) or related to ruptured hepatic artery aneurysms. Congenital APF is a rare condition even in children. In this case report, we describe a 73-year-old woman diagnosed as APF by ultrasonography, computed tomography, and hepatic artery selective arteriography. The fistula was embolized twice but failed, and she still suffered from alimentary tract hemorrhage. Then, selective arteriography of the hepatic artery was performed again and venae coronaria ventriculi and short gastric vein were embolized. During the 2-year follow-up, the patient remained asymptomatic. We therefore argue that embolization of venae coronaria ventriculi and short gastric vein may be an effective treatment modality for intrahepatic APF with severe upper gastrointestinal bleeding. |
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Keywords: | Congenital intrahepatic arterioportal fistula Liver Embolization Portal hypertension Angiography |
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