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Ruptured pancreaticoduodenal pseudoaneurysm causing arterioportal fistula: combined transarterial and transportal embolization

BACKGROUND: 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 pseu...

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Autores principales: Waguri, Nobuo, Azumi, Rie, Osaki, Akihiko, Sato, Munehiro, Aiba, Tsuneo, Furukawa, Koichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524934/
https://www.ncbi.nlm.nih.gov/pubmed/32990860
http://dx.doi.org/10.1186/s42155-020-00165-8
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author Waguri, Nobuo
Azumi, Rie
Osaki, Akihiko
Sato, Munehiro
Aiba, Tsuneo
Furukawa, Koichi
author_facet Waguri, Nobuo
Azumi, Rie
Osaki, Akihiko
Sato, Munehiro
Aiba, Tsuneo
Furukawa, Koichi
author_sort Waguri, Nobuo
collection PubMed
description BACKGROUND: 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. CASE PRESENTATION: 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. CONCLUSION: 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.
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spelling pubmed-75249342020-10-14 Ruptured pancreaticoduodenal pseudoaneurysm causing arterioportal fistula: combined transarterial and transportal embolization Waguri, Nobuo Azumi, Rie Osaki, Akihiko Sato, Munehiro Aiba, Tsuneo Furukawa, Koichi CVIR Endovasc Case Report BACKGROUND: 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. CASE PRESENTATION: 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. CONCLUSION: 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. Springer International Publishing 2020-09-29 /pmc/articles/PMC7524934/ /pubmed/32990860 http://dx.doi.org/10.1186/s42155-020-00165-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Case Report
Waguri, Nobuo
Azumi, Rie
Osaki, Akihiko
Sato, Munehiro
Aiba, Tsuneo
Furukawa, Koichi
Ruptured pancreaticoduodenal pseudoaneurysm causing arterioportal fistula: combined transarterial and transportal embolization
title Ruptured pancreaticoduodenal pseudoaneurysm causing arterioportal fistula: combined transarterial and transportal embolization
title_full Ruptured pancreaticoduodenal pseudoaneurysm causing arterioportal fistula: combined transarterial and transportal embolization
title_fullStr Ruptured pancreaticoduodenal pseudoaneurysm causing arterioportal fistula: combined transarterial and transportal embolization
title_full_unstemmed Ruptured pancreaticoduodenal pseudoaneurysm causing arterioportal fistula: combined transarterial and transportal embolization
title_short Ruptured pancreaticoduodenal pseudoaneurysm causing arterioportal fistula: combined transarterial and transportal embolization
title_sort ruptured pancreaticoduodenal pseudoaneurysm causing arterioportal fistula: combined transarterial and transportal embolization
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524934/
https://www.ncbi.nlm.nih.gov/pubmed/32990860
http://dx.doi.org/10.1186/s42155-020-00165-8
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