title: Portal hypertension, variceal bleeding, and high output cardiac failure secondary to an intrahepatic arterioportal fistula.
abstract: 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.
authors.affiliation: Department of General Surgery, Mayo Graduate School of Medicine, Rochester, Minnesota.
authors.forename: A J
authors.initials: AJ
authors.lastname: Oishi
authors.forename: D M
authors.initials: DM
authors.lastname: Nagorney
authors.forename: K J
authors.initials: KJ
authors.lastname: Cherry
mesh_terms: 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