Abstract:
Intrahepatic arterioportal fistula (IAPF) can be caused by many secondary factors. We report four cases of portal hypertension that were eventually determined to be caused by congenital hepatic arterioportal fistula. The clinical manifestations included ascites, variceal hemorrhage and hepatic encephalopathy. Computed tomography scans from all of the patients revealed the early enhancement of the portal branches in the hepatic arterial phase. All patients were diagnosed using digital subtraction angiography (DSA). DSA before embolization revealed an arteriovenous fistula with immediate filling of the portal venous radicles. All four patients were treated with interventional embolization. The four patients remained in good condition throughout follow-up and at the time of publication. IAPF is frequently misdiagnosed due to its rarity; therefore, clinicians should consider IAPF as a potential cause of non-cirrhotic portal hypertension.
摘要:
肝内动静脉瘘(IAPF)可由许多次要因素引起。我们报告了四例门静脉高压症,最终确定是由先天性肝动脉门脉瘘引起的。临床表现包括腹水,静脉曲张出血和肝性脑病。所有患者的计算机断层扫描显示,肝动脉期门静脉分支的早期增强。所有患者均采用数字减影血管造影(DSA)进行诊断。栓塞前的DSA显示动静脉瘘,门静脉胚根立即充满。所有4例患者均接受介入栓塞治疗。在整个随访期间和发表时,四名患者保持良好状态。IAPF经常因其罕见而被误诊;因此,临床医师应将IAPF视为非肝硬化门脉高压的潜在病因.