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Successful Treatment of a Traumatic Hepatic Arterioportal Fistula: A Case Report  

Mun, Yun Su (Department of Surgery, Eulji University Hospital)
Kwon, Oh Sang (Department of Surgery, Eulji University Hospital)
Lee, Jang Young (Department of Emergency Medicine, Eulji University Hospital)
Park, Gyeong Nam (Department of Emergency Medicine, Eulji University Hospital)
Han, Hyun Young (Department of Radiology, Eulji University Hospital)
Lee, Min Koo (Department of Surgery, Eulji University Hospital)
Publication Information
Journal of Trauma and Injury / v.26, no.1, 2013 , pp. 22-25 More about this Journal
Abstract
Severe blunt abdominal trauma frequently involves the liver. The development of nonsurgical treatment of liver trauma has led to more frequent appearance of unusual complications. A hepatic arterioportal fistula (APF) is a rare complication of liver trauma. We present a case of traumatic APF in a patient with liver trauma. A 31-year-old male visited our emergency department with pain in the right upper abdomen following a traffic accident. Initial physical exam and abdominal computed tomography (CT) revealed liver laceration with hemoperitoneum. An abdominal CT obtained on day 11 revealed early opacification of the right portal vein on the arterial phase. After we had come to suspect an APF of the liver, its presence was confirmed on angiography. It was subsequently managed by using transcatheter coil embolization. In patients with portal hypertension and no evidence or history of cirrhosis, one should consider an APF as a potential etiology if history of liver biopsy or penetrating trauma exists. In a patient with liver trauma, serial abdominal CT is important for early detection and treatment of an APF.
Keywords
Liver trauma; Arterioportal fistula; Embolization;
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1 Farnell MB, Spencer MP, Thompson E, Williams HJ, Find all citations by this author (defaultOr filter your current search Mucha P, Find all citations by this author (default). Or filter your current search Ilstrup DM. Nonoperative management of blunt hepatic trauma in adults. Surgery 1988;104:748-56.
2 Lumsden AB, Allen RC, Sreeram S, Atta H, Salam A. Hepatic arterioportal fistula. Am Surg 1993;59:722-6.
3 Baik JJ, Kim JI, Choi SH, Choi YC, Jun SY, Lee JH, et al. Nonoperative Management of Blunt Liver Trauma. J Korean Soc Traumatol 2005;18:161-71.
4 Defore WW, Mattox KL, Jordan GL, Beall AC. Management of 1590 consecutive cases of liver trauma. Arch Surg 1976; 111:493-7.   DOI
5 Vauthey JN, Tomczak RJ, Helmberger T, Gertsch P, Forsmark C, Caridi J, et al. The arterioportal fistula syndrome: clinic pathologic features, diagnosis, and therapy. Gastroenterology 1997;113:1390-140.   DOI
6 Mathieu D, Larde D, Vasile N. CT features of iatrogenic hepatic arterioportal fistulae. J Comput Assist Tomogr 1983; 7:810-4.   DOI
7 Strodel WE, Eckhauser FE, Lemmer JH, Whitehouse WM, Williams DM. Presentation and perioperative management of arterioportal fistulas. Arch Surg 1987;122:563-71.   DOI
8 Applbaum YN, Renner JW. Steel coil embolization of hepatoportal fistulae. Cardiovasc Interv Radiol 1987;10:75-9.   DOI
9 Basile A, Saluzzo CM, Lupattelli T, Carbonatto P, Bottari A, Mundo E, et al. Nonoperative management of iatrogenic lesions of celiac branches by using transcatheter arterial embolization. Surg Laparosc Endosc Percutan Tech 2004;14: 268-75.