Hepatoportal arteriovenous fistula treated with detachable balloon embolotherapy

Hepatic artery to portal vain fistulas were first reported in 1892. Symptoms of portal hypertension usually occur within weeks to months, once the fistula develops. Various attempts at surgical occlusion and embolization, with varying results, have been reported. This report is of a 33-yr-old woman who, 23 yrs after an automobile accident, was admitted with ascites and diagnosed as having a right hepatic artery-to-portal vein fistula (RHAPVF), which was successfully occluded via detachable balloon embolic therapy. The ascites resolved within 3 days of the embolotherapy, and subsequent follow-up revealed no recurrence of ascites during the next 18 months.