J Korean Soc Traumatol.  2013 Mar;26(1):22-25.

Successful Treatment of a Traumatic Hepatic Arterioportal Fistula: A Case Report

• Mun YS
• Kwon OS
• Lee JY
• Park GN
• Han HY
• Lee MK

Abstract

Severe blunt abdominal trauma frequently involves the liver. The development of nonsurgical treatment of liver trauma has led to more frequent appearance of unusual complications. A hepatic arterioportal fistula (APF) is a rare complication of liver trauma. We present a case of traumatic APF in a patient with liver trauma. A 31-year-old male visited our emergency department with pain in the right upper abdomen following a traffic accident. Initial physical exam and abdominal computed tomography (CT) revealed liver laceration with hemoperitoneum. An abdominal CT obtained on day 11 revealed early opacification of the right portal vein on the arterial phase. After we had come to suspect an APF of the liver, its presence was confirmed on angiography. It was subsequently managed by using transcatheter coil embolization. In patients with portal hypertension and no evidence or history of cirrhosis, one should consider an APF as a potential etiology if history of liver biopsy or penetrating trauma exists. In a patient with liver trauma, serial abdominal CT is important for early detection and treatment of an APF.

Keyword

Liver trauma; Arterioportal fistula; Embolization

MeSH Terms

Abdomen
Accidents, Traffic
Angiography
Biopsy
Emergencies
Fibrosis
Fistula
Hemoperitoneum
Humans
Hypertension, Portal
Lacerations
Liver
Male
Portal Vein