title: Detachable balloon embolization of an aneurysmal gastroduodenal arterioportal fistula.
abstract: Extrahepatic arteriovenous fistulas involving the gastroduodenal artery and the portal venous system are rare and almost always a late complication of gastric surgery. Secondary portal hypertension and mesenteric ischemia may provoke abdominal pain, upper and lower gastrointestinal hemorrhage, diarrhea, and weight loss. Until recently, surgical excision has been the therapy of choice with excellent results. The authors report a case of gastroduodenal arterioportal fistula with a rare large interpositioned aneurysm in a cardiopulmonary-compromised patient who was considered a non-surgical candidate. The gastroduodenal arterioportal fistula was occluded endovascularly by means of a detachable balloon. A survey of the literature of this rare type of arterioportal fistula is included.
authors.affiliation: Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium. Luc.Defreyne@rug.ac.be
authors.forename: Luc
authors.initials: L
authors.lastname: Defreyne
authors.forename: Ignace
authors.initials: I
authors.lastname: De Schrijver
authors.forename: Peter
authors.initials: P
authors.lastname: Vanlangenhove
authors.forename: Marc
authors.initials: M
authors.lastname: Kunnen
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis; D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging*; D001164:Arteriovenous Fistula / Q000209:etiology / Q000628:therapy*; D002404:Catheterization / Q000295:instrumentation*; D004386:Duodenum / Q000098:blood supply*; D004621:Embolization, Therapeutic; D017809:Fatal Outcome; D005743:Gastrectomy / Q000009:adverse effects; D024405:Gastroepiploic Artery / Q000002:abnormalities; D006801:Humans; D008297:Male; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging; D013270:Stomach / Q000098:blood supply; D014057:Tomography, X-Ray Computed