Portal hypertension, variceal bleeding, and high output cardiac failure secondary to an intrahepatic arterioportal fistula.
Intrahepatic arterioportal fistulas (APF) are uncommon complications following hepatic trauma. Large fistulas can result in portal hypertension and cardiovascular compromise. A 46-year-old patient is described who presented with portal hypertension, variceal bleeding, and high output cardiac failure due to a large intrahepatic APF. Surgical closure of the APF by hepatic resection successfully resolved the portal hypertension, prevented further variceal hemorrhage, and restored normal cardiovascular function.
Oishi
A J
AJ
Department of General Surgery, Mayo Graduate School of Medicine, Rochester, Minnesota.
Nagorney
D M
DM
Cherry
K J
KJ
D017541:Aneurysm, False / Q000209:etiology / Q000601:surgery; D001164:Arteriovenous Fistula / Q000150:complications* / Q000601:surgery; D002302:Cardiac Output / Q000502:physiology*; D004932:Esophageal and Gastric Varices / Q000209:etiology* / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006333:Heart Failure / Q000209:etiology* / Q000601:surgery; D006498:Hepatectomy; D006499:Hepatic Artery / Q000293:injuries / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000601:surgery; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000293:injuries* / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000601:surgery