Hepatic Arterioportal Fistula: A Curable Cause of Portal Hypertension in Infancy

Billing, J. Stephen; Jamieson, Neville V.

doi:10.1155/1997/58026

Cited by 18 publications

(10 citation statements)

References 10 publications

(17 reference statements)

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“…In case 1 direct communication of the coeliac artery and portal vein was seen confirming hepatic AV fistula. The features of dilated portal vein and hepatic artery, with pulsatile portal vein flow and multiple pulsatile vessels, are similar to those seen in dogs and human beings with hepatic AV fistulae (Bailey and others 1988, Billing and Jamieson 1997, Lamb 1998, Szatmári and others 2000, 2004a, Schaeffer and others 2001. Hepatic AV fistulae in animals are normally congenital and usually result in portal hypertension as in this case.…”

Section: Discussionsupporting

confidence: 61%

Ultrasonographic diagnosis of unusual portal vascular abnormalities in two cats

McConnell

Sparkes

Ladlow

et al. 2006

J of Small Animal Practice

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Two cases of ascites secondary to portal vascular abnormalities associated with portal hypertension are described. In the first case a five-month-old cat was presented with recurrent ascites and investigations showed that the underlying cause was a hepatic arteriovenous fistula. Ultrasonography showed direct communication of the coeliac artery and right branch of the portal vein. There was also hepatofugal flow in the main portal vein consistent with portal hypertension. The ultrasonographic features were similar to those seen in dogs with hepatic arteriovenous fistulae. In the second case, ascites, portal hypertension and an intraluminal mass in the main portal vein was diagnosed in a 16-year-old cat that had been presented with hyperthyroidism and hepatomegaly. Acquired portosystemic collaterals involving the left renal vein were present. Additional diagnostic investigations were not permitted. Ultrasonography was useful in both cases to document portal hypertension and the underlying cause.

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Section: Discussionsupporting

confidence: 61%

Ultrasonographic diagnosis of unusual portal vascular abnormalities in two cats

McConnell

Sparkes

Ladlow

et al. 2006

J of Small Animal Practice

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“…A surgical approach should be considered for fistulae that do not resolve after several trials of embolization (14,33,50,64). Until sufficient comparative data are available, surgery should be considered as the initial treatment of patients with complex IAPF.…”

Section: Managementmentioning

confidence: 99%

The Congenital Intrahepatic Arterioportal Fistula Syndrome

Norton

Jacobson²,

Moroz³

et al. 2006

J. pediatr. gastroenterol. nutr.

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Congenital intrahepatic arterioportal fistula is a rare but treatable cause of portal hypertension for which early recognition may lead to successful radiological management. We report an infant presenting with severe failure to thrive, melena and splenomegaly due to a congenital intrahepatic arterioportal fistula, successfully ablated after multiple trials of superselective transarterial embolization. Comprehensive review of congenital cases provides an understanding of the key clinical features defining this syndrome. A classification system is proposed, upon which treatment decisions may be based.

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“…Hence, they may be difficult to treat without a combination of surgery and embolization. Partial hepatectomy is associated with high rates of mortality and morbidity [29,30]. In the current case, our team resisted the idea of performing such an extensive procedure because of the extreme malnutrition of the child.…”

Section: Discussionmentioning

confidence: 82%