Lu ZY, Ao JY, Jiang TA, Peng ZY, Wang ZK. A large congenital and solitary intrahepatic arterioportal fistula in an old woman. World J Gastroenterol 2009; 15(13): 1656-1659 [PMID: 19340914 DOI: 10.3748/wjg.15.1656]
Corresponding Author of This Article
Jian-Yang Ao, MD, Department of Ultrasound, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China. aojysili@126.com
Article-Type of This Article
Case Report
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World J Gastroenterol. Apr 7, 2009; 15(13): 1656-1659 Published online Apr 7, 2009. doi: 10.3748/wjg.15.1656
A large congenital and solitary intrahepatic arterioportal fistula in an old woman
Zhen-Ya Lu, Jian-Yang Ao, Tian-An Jiang, Zhi-Yi Peng, Zhan-Kun Wang
Zhen-Ya Lu, Zhan-Kun Wang, Department of Internal Medicine, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Jian-Yang Ao, Tian-An Jiang, Department of Ultrasound, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Zhi-Yi Peng, Department of Radiology, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Lu ZY wrote the article; Ao JY analyzed the images; Jiang TA, Peng ZY and Wang ZK provided their advices.
Correspondence to: Jian-Yang Ao, MD, Department of Ultrasound, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China. aojysili@126.com
Telephone: +86-571-87236516
Fax: +86-571-87236514
Received: January 4, 2009 Revised: February 24, 2009 Accepted: March 3, 2009 Published online: April 7, 2009
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.
