Open AccessIsolated arterioportal fistula presenting with variceal hemorrhage
Author(s) -
Anupama Nookala,
Behnam Saberi,
Ramon Ter-Oganesyan,
Gary C. Kanel,
Phillip Duong,
Takeshi Saito
Publication year - 2013
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v19.i17.2714
Subject(s) - medicine , portal hypertension , malignancy , telangiectasia , embolization , fistula , etiology , radiology , hemostasis , surgery , cirrhosis
We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension. Etiologies for APFs are comprised of precipitating trauma, malignancy, and hereditary hemorrhagic telangiectasia, but these were not the case in our patient. Idiopathic APFs are usually due to congenital vascular abnormalities and thus usually present in the pediatric setting. This is one of the first cases of adult-onset isolated APF who presented with portal hypertension and was successfully managed through endoscopic hemostasis and subsequent interventional radiological embolization.