Congenital, solitary, large, intrahepatic arterioportal fistula in a child: management and review of the literature.

Kumar, Nagappan;de Ville de Goyet, Jean;Sharif, Khalid;McKiernan, Patrick;John, Philip
(2003) Pediatric radiology — Vol. 33, n° 1, p. 20-23 (2003)

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Authors
  • Kumar, Nagappan
    Author
  • de Ville de Goyet, Jeanorcid-logoUCLouvain
    Author
  • Sharif, Khalid
    Author
  • McKiernan, Patrick
    Author
  • John, Philip
    Author
Abstract
Congenital intrahepatic arterioportal fistula (APF) is a rare condition. In most cases, the symptoms and complications develop during infancy. We report here the incidental finding of a large and solitary congenital APF in a 13-year-old boy, with subsequent related clinical complications. At angiography, an APF connecting the left hepatic artery and the left branch of the portal vein (PV) was demonstrated with reversed flow in the left and main PV. The fistula was successfully occluded, in a single embolisation session, using an Amplatzer occlusion device. This was associated with immediate restoration of normal hepatopetal flow in the PV and followed by resolution of the clinical signs of portal hypertension. This patient is the oldest child with congenital intrahepatic APF to be reported. We emphasise the interest of using a large device (Amplatzer) to occlude a solitary large APF in a single session and, more importantly, to avoid other possible complications related to embolisation.
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Citations

Kumar, N., de Ville de Goyet, J., Sharif, K., McKiernan, P., & John, P. (2003). Congenital, solitary, large, intrahepatic arterioportal fistula in a child: management and review of the literature. Pediatric radiology, 33(1), 20-23. https://doi.org/10.1007/s00247-002-0764-x (Original work published 2003)