Intrahepatic arterioportal fistulas(APFs)are abnormal hepatic artery and portal vein(PV)communications that develop as a result of congenital malformation,trauma,ruptured hepatic aneurysm,cirrhosis,tumor-related chang...Intrahepatic arterioportal fistulas(APFs)are abnormal hepatic artery and portal vein(PV)communications that develop as a result of congenital malformation,trauma,ruptured hepatic aneurysm,cirrhosis,tumor-related changes,biopsy,chemotherapy or iatrogenic causes[1,2].The most common symptoms are gastrointestinal bleeding and ascites secondary to portal hypertension;other symptoms include abdominal pain,pyrexia,edema,back pain and jaundice[3].The main goal of therapy is to decrease the portal pressure with variceal bleeding being the absolute indi-cation for surgical management.Transarterial embolization(TAE)should be the first choice to treat APFs,while resection,portocaval shunt and even transplantation may cure APFs in the case of TAE failure[4].In previous reports,caudate lobe-sparing subtotal hep-atectomy(CLSSH)has been applied for the treatment of primary hepatolithiasis and hepatocellular carcinoma[5,6].As far as we know,this is the first report describing CLSSH as treatment for an extensive intrahepatic APF,which involved segments 2 to 8,with corresponding hypertrophy of the caudate lobe.展开更多
基金supported by a grant from the National Natural Science Foundation of China(81930119).
文摘Intrahepatic arterioportal fistulas(APFs)are abnormal hepatic artery and portal vein(PV)communications that develop as a result of congenital malformation,trauma,ruptured hepatic aneurysm,cirrhosis,tumor-related changes,biopsy,chemotherapy or iatrogenic causes[1,2].The most common symptoms are gastrointestinal bleeding and ascites secondary to portal hypertension;other symptoms include abdominal pain,pyrexia,edema,back pain and jaundice[3].The main goal of therapy is to decrease the portal pressure with variceal bleeding being the absolute indi-cation for surgical management.Transarterial embolization(TAE)should be the first choice to treat APFs,while resection,portocaval shunt and even transplantation may cure APFs in the case of TAE failure[4].In previous reports,caudate lobe-sparing subtotal hep-atectomy(CLSSH)has been applied for the treatment of primary hepatolithiasis and hepatocellular carcinoma[5,6].As far as we know,this is the first report describing CLSSH as treatment for an extensive intrahepatic APF,which involved segments 2 to 8,with corresponding hypertrophy of the caudate lobe.
