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[Portal hypertension secondary to an arterioportal fistula. Treatment by embolization]
Revista Espanola De Enfermedades Digestivas
|September 1, 1991
Insights
A percutaneous liver biopsy may cause arterioportal fistula, leading to esophageal varices and bleeding. This case successfully treated the fistula using embolization with steel coils.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Hepatology
Background:
- Percutaneous liver biopsy is a common diagnostic procedure.
- Arteriovenous fistulas, including arterioportal fistulas (APF), are rare but serious complications.
- Portal hypertension can arise from APF, leading to significant morbidity.
Observation:
- A patient presented with clinical signs of portal hypertension and hemorrhage from esophageal varices.
- Imaging studies, including ultrasound, selective arteriography, and Doppler ultrasound, revealed an arterioportal fistula.
- The fistula was suspected to be a consequence of a recent percutaneous liver biopsy.
Findings:
- Diagnostic imaging confirmed the presence and location of the arterioportal fistula.
- The arterioportal fistula was successfully treated using a minimally invasive endovascular technique.
- Superselective catheterization of the fistula allowed for targeted embolization with steel coils.
Implications:
- Endovascular embolization is an effective treatment for arterioportal fistulas.
- Prompt diagnosis and intervention can prevent life-threatening hemorrhage.
- This case highlights the importance of recognizing APF as a potential complication of liver biopsy.
Abstract:
We report a case of arterioportal fistula which was probably the result of percutaneous liver biopsy. Portal hypertension with hemorrhage by esophageal varices was the clinical presentation. We describe the features of the ultrasound, selective arteriography and Doppler ultrasound examination. The fistula was catheterized superselectively and successfully embolized with steel coils.