Tannuri Ana Cristina Aoun, Tannuri Uenis, Lima Fabiana Roberto, Ricardi Luiz Roberto Schlaich, Leal Antonio José Gonçalves, da Silva Marcos Marques
Pediatric Surgery Division, Pediatric Liver Transplantation Unit and Laboratory of Research in Pediatric Surgery (LIM 30), University of Sao Paulo Medical School, Sao Paulo, Brazil.
J Pediatr Surg. 2009 Oct;44(10):e19-22. doi: 10.1016/j.jpedsurg.2009.07.027.
Intrahepatic arterioportal fistula (IAPF) is a rare cause of portal hypertension in young children. We report the case of a 2-year-old girl with severe undernutrition, chronic watery diarrhea, and gastrointestinal bleeding because of a congenital intrahepatic arterioportal fistula. Radiographic embolization and surgical ligation of the left hepatic artery were attempted, with no resolution of the symptoms. So, a left lobectomy was performed, with excellent results and prompt disappearance of the diarrhea. Hepatectomy should be considered as a definitive and reliable therapy for congenital IAPF.
肝内动脉门静脉瘘(IAPF)是幼儿门静脉高压的罕见病因。我们报告了一名2岁女童的病例,她因先天性肝内动脉门静脉瘘出现严重营养不良、慢性水样腹泻和胃肠道出血。尝试了经放射学栓塞和左肝动脉手术结扎,但症状未缓解。因此,进行了左叶切除术,结果良好,腹泻迅速消失。肝切除术应被视为先天性IAPF的一种确定性和可靠的治疗方法。