 |
|
Presentation and Perioperative Management of Arterioportal Fistulas
William E. Strodel, MD;
Frederic E. Eckhauser, MD;
John H. Lemmer, MD;
Walter M. Whitehouse, Jr, MD;
David M. Williams, MD
Arch Surg. 1987;122(5):563-571.
Abstract
| |
• Arterioportal fistulas (APFs) are usually traumatic in origin and may result in portal hypertension and its complications. Over six years, six patients (aged 20 to 59 years) presented with APFs. Two APFs developed after percutaneous liver biopsy, but only one was complicated (hemobilia). Neither patient was treated operatively. Four APFs occurred two days to three years after gunshot wounds. Three patients presented with gastrointestinal tract hemorrhage. All patients had abdominal bruits. Two patients underwent primary repair. One patient underwent APF resection and replacement of the superior mesenteric artery with autogenous vein. Another patient underwent APF and bowel resection. Three patients survived. One patient died of liver failure. The development of an abdominal bruit in a patient with penetrating abdominal trauma suggests APF and should prompt angiography. Elective repair is recommended before complications of portal hypertension develop.
(Arch Surg 1987;122:563-571)
Author Affiliations
From the Departments of Surgery (Drs Strodel, Eckhauser, Lemmer, and Whitehouse) and Radiology (Dr Williams), University of Michigan Medical Center, Ann Arbor.
Footnotes
Accepted for publication Jan 12, 1987.
Read before the 94th Annual Meeting of the Western Surgical Association, Dearborn, Mich, Nov 18, 1986.
Reprint requests to the Department of Surgery, University of Kentucky Medical Center, 800 Rose St, Lexington, KY 40536 (Dr Strodel).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Endoluminal Management of Arterioportal Fistulae in Liver Transplant Recipients: A Single-Center Experience
Saad et al.
VASC ENDOVASCULAR SURG 2007;40:451-459.
ABSTRACT
|
