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Journal of Trauma and Injury 2013;26(1):22-25.
Successful Treatment of a Traumatic Hepatic Arterioportal Fistula: A Case Report
Yun Su Mun, Oh Sang Kwon, Jang Young Lee, Gyeong Nam Park, Hyun Young Han, Min Koo Lee
1Department of Surgery, Eulji University Hospital, Daejeon, Korea. mklee@eulji.ac.kr
2Department of Emergency Medicine, Eulji University Hospital, Daejeon, Korea.
3Department of Radiology, Eulji University Hospital, Daejeon, Korea.
간열상에 발생한 외상성 간동맥문맥 단락의 치료 1예
문윤수, 권오상, 이장영1, 박경남1, 한현영2, 이민구
을지대학교 의과대학 외과학교실, 1응급의학교실, 2영상의학교실
Received: 26 November 2012   • Revised: 27 November 2012   • Accepted: 5 December 2012
Abstract
Severe blunt abdominal trauma frequently involves the liver. The development of nonsurgical treatment of liver trauma has led to more frequent appearance of unusual complications. A hepatic arterioportal fistula (APF) is a rare complication of liver trauma. We present a case of traumatic APF in a patient with liver trauma. A 31-year-old male visited our emergency department with pain in the right upper abdomen following a traffic accident. Initial physical exam and abdominal computed tomography (CT) revealed liver laceration with hemoperitoneum. An abdominal CT obtained on day 11 revealed early opacification of the right portal vein on the arterial phase. After we had come to suspect an APF of the liver, its presence was confirmed on angiography. It was subsequently managed by using transcatheter coil embolization. In patients with portal hypertension and no evidence or history of cirrhosis, one should consider an APF as a potential etiology if history of liver biopsy or penetrating trauma exists. In a patient with liver trauma, serial abdominal CT is important for early detection and treatment of an APF.
Key Words: Liver trauma; Arterioportal fistula; Embolization


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