Premium
Idiopathic intrahepatic arterioportal fistula treated by hepatectomy assisted by balloon‐occluded retrograde transvenous obliteration: Report of an elderly case
Author(s) -
Kuroda Hirohiko,
Hosho Keiko,
Koda Masahiko,
Murawaki Yoshikazu,
Ouchi Yasufumi,
Kaminou Toshio,
Iwamoto Akemi,
Hirooka Yasuaki
Publication year - 2008
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/j.1872-034x.2008.00341.x
Subject(s) - medicine , fistula , embolization , radiology , portal hypertension , balloon , gastric varices , varices , hepatic encephalopathy , arteriovenous fistula , surgery , cirrhosis
An 80‐year‐old woman with hepatic encephalopathy and esophagogastric varices was admitted. Doppler sonography and arteriography demonstrated an arterioportal fistula in the right anterior superior segment of the liver. Two attempts at transcatheter arterial embolization failed to manage the fistula and portacaval collaterals. We carried out hepatectomy and balloon‐occluded retrograde transvenous obliteration, by which the portal flow changed from hepatofugal to hepatopetal. The resected specimen demonstrated multiple small holes in the right portal vein, which are arterioportal fistula. The underlying liver was normal. After treatment, esophagogastric varices and hepatic encephalopathy were markedly improved. Hepatectomy is useful as a reliable therapy for arterioportal fistula in case of failure of transarterial embolization.