Hepatic arterioportal fistula (APF) in the setting of cirrhosis may aggravate the
preexisting portal hypertension and its complications. Cirrhotic patients undergo
various percutaneous invasive procedures and are at risk of developing an APF. These
should be diagnosed early and should be treated accordingly at the earliest when indicated.
Presently embolization is the treatment of choice with coil embolization as the most
commonly used method. We describe four cases from our institute with a history of
liver parenchymal disease and were found to have acquired APF on imaging. These were
successfully managed with transarterial embolization with resolution or improvement
in their clinical symptoms on follow-up. The present case series and review emphasize
the importance of APF in the setting of liver parenchymal disease and the role of
early diagnosis and therapeutic intravascular interventions.
Keywords
arterioportal fistula - cirrhosis - portal hypertension - embolization - n-BCA glue
