[Portal hypertension in a patient with hepatitic C revealing an iatrogenic arterioportal fistula].
A 67-year-old man with anti-HCV positive serum, was admitted for hematemesis by variceal bleeding. Portal hypertension, which initially was thought to be caused by a post-hepatitis C cirrhosis, was due to a fistula between a right hepatic artery and a right branch of the portal vein. The fistula located under the right liver and the adjacent atrophic hepatic segments, were resected by a bi-segmentectomy VI-VII. The postoperative course was simple. The pathological study of the resected liver showed no cirrhosis but active hepatitis. This arterioportal fistula was probably iatrogenic. Sixteen years before, this patient had undergone a total gastrectomy for cancer, followed by a serious haemorrhage requiring a massive transfusion, which was responsible for the transmission of hepatitis C.
Cheynel
N
N
Service de chirurgie digestive et transplantation, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France.
Pillegand
B
B
Valleix
D
D
Durant-Fontanier
S
S
Sodji
M
M
Pech de Laclause
B
B
Descottes
B
B
D000368:Aged; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D001803:Blood Transfusion; D005743:Gastrectomy / Q000009:adverse effects*; D006499:Hepatic Artery / Q000002:abnormalities; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D007049:Iatrogenic Disease; D008297:Male; D011169:Portal Vein / Q000002:abnormalities; D013274:Stomach Neoplasms / Q000601:surgery