Open liver trauma causing hepatico caval fistula successfully treated by embolization

Abstract

IntroductionTraumatic arteriovenous fistula results from a breach of vascular integrity between a vein and an adjacent artery. Hepato caval fistula is a rare entity. Open surgical approaches have increasingly given way to radiological embolization techniques in the treatment of these arteriovenous fistulae, especially in intrahepatic locations.Case reportWe report the case of a patient diagnosed with a fistula, from the right branch of the liver artery to the right hepatic vein, developed following an open liver trauma. Successful embolization through the transarterial route was achieved with simple outcomes.ConclusionThe interventional radiology for endovascular management has revolutionized the treatment of hepatic liver traumas. The conservative treatment is henceforth the common approach even if hepatic artery or hepatic veins are involved in case of arteriovenous fistula.

Hepatic trauma

“…These fistulas are abnormal communications that can form between intrahepatic vasculature and can involve the arterial, portal, or hepatic venous systems. Traumatic hepatic arterioportal fistulas are much more common than hepatic arterial to hepatic venous fistulas, which is likely due to the larger distance between the hepatic arteries and hepatic veins (29)(30)(31). Arterioportal vascular fistulas are generally managed with coil or microcoil embolization.…”

“…Arterioportal vascular fistulas are generally managed with coil or microcoil embolization. Similarly, two case reports detailed the treatment of the rarer hepatic arterial to hepatic venous fistula with microcoil embolization of the arterial feeding vessel with good angiographic result (29,31). Although the data is currently limited on the indications for treatment of intrahepatic shunts.…”