Open AccessPortal hypertension induced by congenital hepatic arterioportal fistula: Report of four clinical cases and review of the literature
Author(s) -
Danying Zhang,
Shuqiang Weng,
Ling Dong,
Xin Shen,
Xudong Qu
Publication year - 2015
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.v21.i7.2229
Subject(s) - medicine , portal hypertension , digital subtraction angiography , ascites , radiology , fistula , embolization , arteriovenous fistula , portal venous pressure , angiography , hepatic encephalopathy , cirrhosis , surgery
Intrahepatic arterioportal fistula (IAPF) can be caused by many secondary factors. We report four cases of portal hypertension that were eventually determined to be caused by congenital hepatic arterioportal fistula. The clinical manifestations included ascites, variceal hemorrhage and hepatic encephalopathy. Computed tomography scans from all of the patients revealed the early enhancement of the portal branches in the hepatic arterial phase. All patients were diagnosed using digital subtraction angiography (DSA). DSA before embolization revealed an arteriovenous fistula with immediate filling of the portal venous radicles. All four patients were treated with interventional embolization. The four patients remained in good condition throughout follow-up and at the time of publication. IAPF is frequently misdiagnosed due to its rarity; therefore, clinicians should consider IAPF as a potential cause of non-cirrhotic portal hypertension.