Congenital hepatoportal arteriovenous fistula: Report of a case

Fistulae between the hepatic artery and portal vein, known as hepatoportal arteriovenous fistula (HPAVF), most commonly occur secondary to trauma or m alignancy. Congenital HPAVF is an extremely rare anomaly and only 11 pediat ric cases have been documented to date HPAVF causes portal hypertension wit h the reversal of flow in the portal circulation, leading to hyperemia and congestion of the bowel, causing severe ascites, gastrointestinal bleeding, anemia, and malabsorption. The diagnosis is first made by Doppler sonograp hy, then confirmed by angiography. HPAVF is most effectively treated by per forming either ligation of the hepatic artery or percutaneous transcatheter embolization, We describe herein the case of an 8-month-old buy diagnosed to have congenital HPAVF by duplex Doppler sonography and confirmed by digi tal subtraction angiography, who was successfully managed by percutaneous t ranscatheter embolization of the feeding right hepatic artery. A review of the previously reported 11 cases of infants with this unusual anomaly, exam ining presentation, management, and outcome, is also presented.