Publication

Abstract : The CT angiogram showed evidence of arterioportal shunting in segment VII of the liver likely secondary to arterioportal fistula with high-density layering contents suggestive of hemorrhage within the gallbladder and CBD. A digital subtraction angiography (DSA) was done in the view of embolization, super-selective catheterization beyond the fistula done, 018 fiber coils assisted with methyl glue used to embolize the fistula. A repeat CT angiogram showed resolution of the fistula. Four weeks later the same patient underwent donor hepatectomy and the right lobe with MHV was transplanted to the recipient who had cryptogenic chronic liver disease (CLD) with decompensation, the patient and the recipient did well in the postoperative period with no complications and the patient was discharged home on day 7. The stent was removed 4 weeks after surgery. Conclusion: Hepatic arterioportal fistula is a rare complication of liver biopsy; an early diagnosis and aggressive management using a multidisciplinary approach are needed to have a good outcome and liver biopsy should be done with extreme caution in centers where there is expertise