Detachable balloon embolization of an aneurysmal gastroduodenal arterioportal fistula.
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.
Defreyne
Luc
L
Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium. Luc.Defreyne@rug.ac.be
De Schrijver
Ignace
I
Vanlangenhove
Peter
P
Kunnen
Marc
M
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