A hyperdynamic portal syndrome with ascites after endoscopic laser treatment

Laser therapy has gained wide acceptance and application in many medical disciplines. Side effects of laser therapy are rare and the most frequent mainly involve the skin. We describe a patient affected by familial adenomatous polyposis that had been repeatedly controlled and treated endoscopically using an Nd:Yag laser. He presented with a progressive hyperdynamic portal syndrome with ascites caused by some arterovenous fistulas. We hypothesize that a rare side effect of the laser treatment may have caused ischemic and coagulative tissue inflammation that triggered off the pathological communications between the arterial and portal circulation.