Presentation and Perioperative Management of Arterioportal Fistulas

William E. Strodel, Frederic Eckhauser, John H. Lemmer, Walter M. Whitehouse, David M. Williams

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)563-571
Number of pages9
JournalArchives of Surgery
Volume122
Issue number5
DOIs
Publication statusPublished - 1987
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

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