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Lookup NU author(s): Dr John Rose,
Emeritus Professor Oliver James,
Dr Mark Hudson
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A 62-year-old male presented with variceal haemorrhage. Investigation demonstrated a fistula between the left gastric artery and portal vein with a porto-systemic gradient of 35 mm Hg. Variceal bleeding was controlled by a transcatheter embolisation of the fistula, but the patient died of septicaemia three weeks later. The second patient, a 42-year-old male who presented with variceal bleeding was shown to have diffuse arterio-venous fistulae involving the right lobe of the liver with a portosystemic gradient of 25 mm Hg. In this case the variceal bleeding was successfully controlled by insertion of a transjugular intrahepatic portosystemic shunt (TIPS). The pathogenesis of portal hypertension in arterioportal fistulae and the role of interventional radiological techniques in the management of variceal bleeding in these patients is discussed.
Author(s): James OFW; Hudson M; Rose JDG; Aithal GP; Alabdi BJ
Publication type: Article
Publication status: Published
Print publication date: 01/08/1999
ISSN (print): 0106-9543
Publisher: John Wiley & Sons, Inc.
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