A case of portal hypertension caused by intrahepatic arterio-portal fistula formed after percutaneous liver biopsy 35 years previously, markedly improved by transcatheter arterial embolization against the fistula

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  • 肝生検後３５年経過して発症し経カテーテル的肝動脈塞栓術によって門脈圧亢進が著明に改善した肝内動門脈瘻の１例
  • 症例報告 肝生検後35年経過して発症し経カテーテル的肝動脈塞栓術によって門脈圧亢進が著明に改善した肝内動門脈瘻の1例
  • ショウレイ ホウコク カン セイケンゴ 35ネン ケイカシテ ハッショウシ ケイカテーテルテキ カン ドウミャク ソクセンジュツ ニ ヨッテ モンミャクアツ コウシン ガ チョメイ ニ カイゼンシタ カンナイ ドウモンミャクロウ ノ 1レイ

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An 80-year-old woman who had undergone two percutaneous liver biopsies to examine liver dysfunction 35 years previously was admitted for examination of ascites. Laboratory data demonstrated pancytopenia and elevations of transaminases, alkaline phosphatase and γ-glutamyl transpeptidase. Computed tomography demonstrated massive ascites and atrophic liver. Hepatic angiography showed a shunt formation between the dilated right hepatic artery and the right portal vein. Upper gastrointestinal endoscopy demonstrated severe esophageal varices. We diagnosed portal hypertension caused by an intrahepatic arterio-portal fistula. After transcatheter arterial embolization of the fistula, portal vein flow immediately became normalized to a toward-the-liver flow. Subsequently, the ascites and esophageal varices disappeared, along with normalization of laboratory data and liver size. The marked portal hypertension in this case was thought to be caused by gradually increased blood flow through the intrahepatic arterio-portal fistula that formed after percutaneous liver biopsies 35 years previously.<br>

Journal

  • Kanzo

    Kanzo 49 (11), 506-511, 2008

    The Japan Society of Hepatology

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