Strodel W E, Eckhauser F E, Lemmer J H, Whitehouse W M, Williams D M
Arch Surg. 1987 May;122(5):563-71. doi: 10.1001/archsurg.1987.01400170069010.
Arterioportal fistulas (APFs) are usually traumatic in origin and may result in portal hypertension and its complications. Over six years, six patients (aged 20 to 59 years) presented with APFs. Two APFs developed after percutaneous liver biopsy, but only one was complicated (hemobilia). Neither patient was treated operatively. Four APFs occurred two days to three years after gunshot wounds. Three patients presented with gastrointestinal tract hemorrhage. All patients had abdominal bruits. Two patients underwent primary repair. One patient underwent APF resection and replacement of the superior mesenteric artery with autogenous vein. Another patient underwent APF and bowel resection. Three patients survived. One patient died of liver failure. The development of an abdominal bruit in a patient with penetrating abdominal trauma suggests APF and should prompt angiography. Elective repair is recommended before complications of portal hypertension develop.
动门脉瘘（APF）通常源于外伤，可能导致门静脉高压及其并发症。在六年期间，有六名患者（年龄在20至59岁之间）出现了APF。两例APF在经皮肝活检后形成，但只有一例出现并发症（胆道出血）。两名患者均未接受手术治疗。四例APF在枪伤后两天至三年出现。三名患者出现胃肠道出血。所有患者均有腹部杂音。两名患者接受了一期修复。一名患者接受了APF切除并用自体静脉置换肠系膜上动脉。另一名患者接受了APF和肠切除术。三名患者存活。一名患者死于肝功能衰竭。穿透性腹部创伤患者出现腹部杂音提示存在APF，应立即进行血管造影。建议在门静脉高压并发症出现之前进行择期修复。
