Document Detail


Arterioportal fistulas: introduction of a novel classification with therapeutic implications.
MedLine Citation:
PMID:  16627220     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Arterioportal fistulas (APFs) are arteriovenous communications between the splanchnic arteries and the portal vein that represent an infrequent cause of presinusoidal portal hypertension. They can be acquired or congenital. Penetrating hepatic trauma, including liver biopsies, represent the most common etiology. They can be asymptomatic or manifest with portal hypertension. An abdominal bruit is a valuable physical finding. Persistence of an APF can cause hepatoportal sclerosis and possibly portal fibrosis. A detailed radiologic evaluation is mandatory. One must differentiate between small peripheral intrahepatic APFs (type 1) and large central APFs (type 2). The former usually resolve spontaneously, whereas the latter can cause portal hypertension and hepatic parenchymal changes. Type 1 APFs caused by needle injury can be followed by Doppler ultrasound. All other fistulas need treatment. Arterioportal fistulas are first treated by transcatheter embolization. Surgical approaches are reserved for complex cases. Congenital APFs (type 3) are diffuse and intrahepatic and can be difficult to manage. Overall, the prognosis is good. Herein, we propose a novel classification for arterioportal fistulas with therapeutic implications.
Authors:
Eduardo A Guzman; Laurence E McCahill; Frederick B Rogers
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  10     ISSN:  1091-255X     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-21     Completed Date:  2006-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  543-50     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Vermont, Burlington, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Arteriovenous Fistula / classification*,  etiology,  therapy
Embolization, Therapeutic
Fibrosis
Hepatic Artery*
Humans
Hypertension, Portal / diagnosis
Mesenteric Artery, Superior
Portal Vein*
Prognosis
Sclerosis
Splenic Artery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Oncolytic herpes viral therapy is effective in the treatment of hepatocellular carcinoma cell lines.
Next Document:  Helicobacter pylori extract induces nuclear factor-kappa B, activator protein-1, and cyclooxygenase-...