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KMID : 0360720130260010022
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Journal of the Korean Society Traumatology
2013 Volume.26 No. 1 p.22 ~ p.25
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Successful Treatment of a Traumatic Hepatic Arterioportal Fistula: A Case Report
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Moon Yun-Su
Kwon Oh-Sang
Lee Jang-Young
Park Gyeong-Nam
Han Hyun-Young
Lee Min-Koo
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Abstract
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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.
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KEYWORD
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Liver trauma, Arterioportal fistula, Embolization
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