| Arterioportal fistulas: introduction of a novel classification with therapeutic implications. | |
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MedLine Citation:
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PMID: 16627220 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Eduardo A Guzman; Laurence E McCahill; Frederick B Rogers |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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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:
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Created Date: 2006-04-21 Completed Date: 2006-10-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: United States |
Other Details:
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Languages: eng Pagination: 543-50 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Vermont, Burlington, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Arteriovenous Fistula
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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
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