title: Mesenteric ischemia: an unusual presentation of traumatic intrahepatic arterioportal fistula.
abstract: Traumatic hepatic arterioportal fistulae (APF) are described infrequently as sequelae of hepatic trauma. These anomalies are usually associated with blunt hepatic trauma or iatrogenic injury. The majority of APF present within weeks to months of injury with gastrointestinal hemorrhage, hemobilia, abdominal pain, and diarrhea. When presenting remotely APFs are associated with portal hypertension, heart failure, gastrointestinal hemorrhage, ascites, and splenomegaly. We report an unusual case of mesenteric ischemia due to an APF that resulted from a penetrating liver injury 20 years before presentation. Successful treatment of the APF was achieved by intravascular catheter occlusion resulting in resolution of symptoms.
authors.affiliation: Department of Surgery, University of Mississippi School of Medicine, Jackson, 39216, USA.
authors.forename: W P
authors.initials: WP
authors.lastname: English
authors.forename: M B
authors.initials: MB
authors.lastname: Johnson
authors.forename: K R
authors.initials: KR
authors.lastname: Borman
authors.forename: W W
authors.initials: WW
authors.lastname: Turner
mesh_terms: D000328:Adult; D001164:Arteriovenous Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D004621:Embolization, Therapeutic; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D008099:Liver / Q000293:injuries*; D008297:Male; D008643:Mesentery / Q000098:blood supply* / Q000000981:diagnostic imaging; D011169:Portal Vein / Q000000981:diagnostic imaging; D011859:Radiography; D014951:Wounds, Stab / Q000150:complications*