Table of Contents
HPB Surgery
Volume 7, Issue 1, Pages 53-59
Case Report

Portal Hypertension, Variceal Bleeding, and High Output Cardiac Failure Secondary to an Intrahepatic Arterioportal Fistula

1Department of General Surgery, Mayo Graduate School of Medicine, Rochester, Minnesota, USA
2Department of General Surgery, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
3Division of Vascular Surgery, Mayo Clinic, Rochester, Minnesota, USA

Accepted 21 January 1993

Copyright © 1993 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Intrahepatic arterioportal fistulas (APF) are uncommon complications following hepatic trauma. Large fistulas can result in portal hypertension and cardiovascular compromise. A 46-year-old patient is described who presented with portal hypertension, variceal bleeding, and high output cardiac failure due to a large intrahepatic APF. Surgical closure of the APF by hepatic resection successfully resolved the portal hypertension, prevented further variceal hemorrhage, and restored normal cardiovascular function.