Portal hypertension due to traumatic hepatic arterioportal fistula: reportof successful embolization

We report a case of severe portal hypertension due to a post-traumatic hepa tic arterioportal fistula. A 77-year-old male patient was admitted for abdo minal pain, inappetence and weight loss. Further clinical signs were ascite s and splenomegaly. Sonography showed a marked enlargement of an arteriopor tal fistula, which was diagnosed some years before as a consequence of abdo minal trauma during the Second World War. Angiography demonstrated an impos ing dilatation of the right hepatic artery filling an intrahepatic pseudoan eurysmatic cavity with fistula formation to the portal vein. By means of se lective hepatic artery embolization, complete occlusion of the right hepati c artery and the arterioportal fistula was achieved. Within 4 weeks the pat ient recovered and sonography showed disappearance of ascites and splenomeg aly. Eur J Gastroenterol Hepatol 10: 1057-1059 (C) 1998 Lippincott Williams & Wilkins.