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An infant boy with severe portal hypertension developed failure to thrive and malabsorption. Clinical findings and ultrasonography suggested the presence of an arteriovenous shunt, and hepatic angiography confirmed the diagnosis and outlined the anatomy of the vascular malformation, which was an intrahepatic arterioportal fistula. Ligature of the hepatic artery gave excellent results as demonstrated by disappearance of portal hypertension and malabsorption and subsequent growth catch-up.

A case of hepatic artery portal fistula, presenting with bleeding esophageal varices five months following a liver biopsy for cirrhosis, is presented. The angiographic features of the lesion are illustrated and the pertinent literature concerning etiology of hepatic arterioportal shunts is reviewed.

An intrahepatic arterioportal fistula causing portal hypertension was successfully palliated with steel coils. The patient remains well 2 1/2 years after embolization. The 13 previously reported cases of transcatheter embolization of large intrahepatic arterioportal fistulae are reviewed. Percutaneous transcatheter embolization with suitable embolic material should be preferred to surgery in the treatment of these fistulae.

A 70-year-old man presented with a history of alcohol abuse and three prior episodes of bleeding from esophageal varices. On physical examination, he had ascites and a bruit over the right lobe of the liver. A diagnosis of hepatoma was established by needle biopsy. Radionuclide studies demonstrated a photon-deficient region in the liver by Tc-99m sulfur colloid, which picked up Ga-67 citrate. Angiography with Tc-99m labeled RBCs demonstrated an arterioportal fistula and a caput medusa.

The arteriographic findings associated with hepatic trauma were studied in 87 patients. Arterial occlusion, marked extravasation, slight hemorrhage, pseudo-tumor, subcapsular hematoma, arteriobiliary fistula, and arterioportal fistula were seen either in isolation or randomly grouped. Differentiation of these lesions is discussed. Apparent disagreements between the anatomical appearances and the radiographic images at times arise, and a complete knowledge of arterial anatomy is necessary to avoid underestimation of the size or nature of the lesion.

The commercial availability of double-lumen balloon catheters has added a new tool for the angiographer in controlling gastrointestinal bleeding. Our report describes a situation in which the unique properties of this catheter were quite effective in controlling life-threatening hemorrhage.

A hepatic arterioportal fistula was visualized in a patient with hepatocellular carcinoma by sequential computed tomography (CT) after rapid bolus injection of contrast medium. Early contrast staining was demonstrated in the trunk and branches of the portal vein. The CT findings corresponded with those of celiac angiography.

A case of traumatic intrahepatic arterioportal fistula successfully treated surgically is reported. Pre-operative angiography is essential for precise anatomical location and a definitive diagnosis.

Arterioportal fistula (APF) is a rare disorder of the mesenteric vasculature Patients with arterioportal fistula may present with complications, including portal hypertension (gastrointestinal bleeding and ascites), heart failure or intestinal ischemia. Furthermore, membranoproliferative glomerulonephritis (MPGN) subsequent to portosystemic shunts have been reported. In this paper, we report on a case of arterioportal fistula complicated with membranoproliferative glomerulonephritis and treated with an endovascular embolization procedure. A rapid improvement and complete resolution of ascites were observed following the treatment. © 2016, Nobelmedicus. All rights reserved.