Traumatic intrahepatic arterioportal fistula

Mesenteric Ischemia: An Unusual Presentation of Traumatic Intrahepatic Arterioportal Fistula

“…Transcatheter embolization with its minimal morbidity has become the mainstay of treatment for this condition.? : 17,18 The two treatment modalities may be used together in situations of continued hemorrhage for hepatic trauma found at the time of celiotomy. Increased use of arteriography has led to the increased diagnosis of APF; however, many of these are small and asymptomatic and close spontaneously.3.…”

“…Embolization has been used successfully to treat APF in a number of patients.18 Currently radiographically directed occlusion is the primary treatment of APF, whereas surgery with its associated morbidity and mortality is reserved for large fistulae that fail radiographic intervention.10, 18 Because over 70 per cent of hepatic circulation and 50 per cent of the liver's oxygen supply are provided by the portal system hepatic ischemia is not expected with complete hepatic artery occlusion should this be necessary to control hemorrhage. 18 In the current case the patient presented with moderate ascites; however postprandial abdominal pain and diarrhea were his chief complaints. Portal pressure was not measured.…”

Hepatic Angiography

“…7). A more extensive laceration of the liver may be associated with subcapsular hematoma, traumatic aneurysm, arterioportal fistula [46] or arteriobiliary fistula [8]. Other 1.…”