Waguri Nobuo, Azumi Rie, Osaki Akihiko, Sato Munehiro, Aiba Tsuneo, Furukawa Koichi
Department of Gastroenterology and Hepatology, Niigata City General Hospital, 467-3 Shumoku, Chuo-ku, Niigata, 950-1197, Japan.
CVIR Endovasc. 2020 Sep 29;3(1):72. doi: 10.1186/s42155-020-00165-8.
Arterioportal fistulas are rare vascular disorders of the abdominal viscera. They are arteriovenous communications between the splanchnic arteries and the portal vein or its tributaries. We herein report a case of an extrahepatic arterioportal fistula that was caused by rupture of a pseudoaneurysm of the pancreaticoduodenal artery and successfully treated with embolization using a combination of the arterial and percutaneous transhepatic portal venous approaches.
A 79-year-old man was transferred to our hospital because of the sudden appearance of a hematoma containing a large pseudoaneurysm in the mesentery of the duodenum. Emergency abdominal angiography revealed that a pseudoaneurysm of the anterior inferior pancreaticoduodenal arterial branch had perforated into the portal system (arterioportal fistula). We performed coil embolization via the inflow artery and portal vein using a percutaneous transhepatic approach. The patient recovered without complications and was discharged.
This rare vascular disorder was successfully treated with an unplanned combination therapy. We believe that flexible strategy changes led to the successful treatment in this case.
动门脉瘘是腹部脏器罕见的血管疾病。它们是内脏动脉与门静脉或其分支之间的动静脉交通。我们在此报告一例肝外动门脉瘘，其由胰十二指肠动脉假性动脉瘤破裂引起，并通过动脉和经皮经肝门静脉联合途径栓塞成功治疗。
一名79岁男性因十二指肠系膜突然出现含巨大假性动脉瘤的血肿而被转至我院。急诊腹部血管造影显示，胰十二指肠下前动脉分支的假性动脉瘤已穿破进入门静脉系统（动门脉瘘）。我们采用经皮经肝途径通过流入动脉和门静脉进行弹簧圈栓塞。患者康复且无并发症，随后出院。
这种罕见的血管疾病通过非计划的联合治疗得以成功治疗。我们认为，灵活的策略调整促成了该病例的成功治疗。
