Hepatoportal Arteriovenous Fistula and Portal Hypertension in an Infant

PEDIATRICS ◽  
1977 ◽  
Vol 60 (6) ◽  
pp. 921-924
Author(s):  
M. A. Helikson ◽  
D. L. Shapiro ◽  
J. H. Seashore
Keyword(s):  
Heart Failure ◽  
Portal Hypertension ◽  
Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Vascular Lesions ◽  
New Haven ◽  
Arteriovenous Shunting ◽  
Pregnancy And Delivery ◽  
History Of ◽  
Haven Hospital

Hepatic vascular lesions are rare, particularly in children. Hemangioendotheliomas frequently cause congestive heart failure secondary to systemic arteriovenous shunting of blood, whereas fistulas between the hepatic artery and portal vein usually produce portal hypertension and its complications. We report the fourth, and youngest, child with hepatoportal arteriovenous fistula (AVF). The clinical presentation of acute portal hypertension mimicking intestinal obstruction is unique. CASE REPORT A 5-week-old, 3.7-kg girl was admitted to Yale-New Haven Hospital with a one-week history of vomiting, diarrhea, and abdominal distention. Pregnancy and delivery had been uncomplicated. Findings of the physical examination were normal except for the abdomen which was distended and tympanitic, with high-pitched bowel sounds.

scholarly journals Portal hypertension caused by postoperative superior mesenteric arteriovenous fistula

2012 ◽  
Vol 69 (7) ◽  
pp. 623-626
Author(s):  
Dusan Popovic ◽  
Milan Spuran ◽  
Lazar Davidovic ◽  
Tamara Alempijevic ◽  
Milenko Ugljesic ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Arteriovenous Fistula ◽  
Mesenteric Artery ◽  
Bowel Resection ◽  
Abdominal Distension ◽  
Small Bowel Resection ◽  
Cystic Dilatation ◽  
History Of ◽  
Mesenteric Vessels ◽  
Hypertension Development

Introduction. Arteriovenous fistula of the superior mesenteric blood vessels is a rare complicaton in abdominal surgery. Case report. We presented a 49-year-old man with cramplike abdominal pain, abdominal distension and weight loss symptoms, with a history of previous small bowel resection and right colectomy, due to Crohn disease, 16 years ago. Clinical examination revealed a paraumbilical pulsation with systolic murmur and thrill. Ultrasonography and computed tomography revealed cystic dilatation of the superior mesenteric vein, hepatomegaly and ascites. Upper endoscopy revealed grade I esophageal varices with portal hypertensive gastropathy. The diagnosis of arteriovenous fistula between superior mesenteric artery and vein was confirmed by angiogram of the superior mesenteric vessels and resection of the fistula was performed. Control examination after nine months showed no signs of portal hypertension. Conclusion. Early diagnosis and treatment of mesenteric blood vessel arteriovenous fistula prevents portal hypertension development and its complications.

Abstract 16705: Prevalence and Outcomes Among Hospitalized Patients With Covid-19 and Atrial Fibrillation or Flutter

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Zaniar Ghazizadeh ◽  
Chad Gier ◽  
Avinainder Singh ◽  
Lina Vadlamani ◽  
Maxwell Eder ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Acute Kidney Injury ◽  
Adverse Events ◽  
Cardiac Injury ◽  
Kidney Injury ◽  
Prior History ◽  
New Haven ◽  
History Of ◽  
Record Review

Introduction: The prevalence and outcomes of patients hospitalized with COVID-19 with atrial fibrillation and atrial flutter (AF/FL) remains unclear. Methods: The Yale Cardiovascular COVID Registry is a cohort study of adult patients >=18 years hospitalized with COVID-19 in the Yale New Haven Health System. Retrospective medical record review was performed on consecutive patients from the registry admitted between March and June 2020. We calculated the rates of prior and in-hospital AF/FL and evaluated the unadjusted rates of in-hospital adverse events for both groups; we then calculated the adjusted odds of adverse events using logistic regression. Results: Among 396 patients, the mean age was 68.2, 52.3% were men, 56.4% were Caucasian, 28.4% Black and 16.9% Hispanic. 15.7% of patients had prior history of AF/FL. 19.9% of patients had in-hospital AF/FL, 7.83% of which did not have a prior history of AF/FL. Patients with in-hospital AF/FL had significantly more CV complications compared to those without including cardiac injury (78.5% vs 42.7%, p=0.000), type 2 myocardial infarction (53.3 vs 30.3%, p=0.002), and heart failure (32.9% vs 9.2%, p=0.000). In-hospital AF/FL was associated with significantly worse outcomes related to COVID-19 including ICU survival (OR 0.22 [0.08-0.59], p=0.002), heart failure (5.19 [2.56-10.5], p=0.000), myocardial injury (OR 2.87 [1.49-5.49], p=0.001), acute kidney injury (OR 2.02 [1.09-3.74], p=0.027), dialysis (OR 4.07 [1.38-12.03], p=0.011) and hospice/death (OR 2.47 [1.35-4.53], p=0.004). Conclusion: AF/FL are common in patients hospitalized with COVID-19 and these patients had significantly worse outcomes, including lower odds of ICU survival and higher odds of heart failure, acute kidney injury, dialysis and hospice/death.

scholarly journals Traumatic Brachial Arteriovenous Fistula - History Also Matters

2021 ◽  
Vol 10 (27) ◽  
pp. 2042-2043
Author(s):  
Debasish Das ◽  
Debasis Acharya ◽  
Jogendra Singh ◽  
Subhas Pramanik
Keyword(s):  
Arteriovenous Fistula ◽  
Traumatic Injury ◽  
Coronary Intervention ◽  
Arteriovenous Shunting ◽  
Av Fistula ◽  
Delay In Diagnosis ◽  
Transradial Access ◽  
History Of ◽  
Post Traumatic ◽  
Transradial Intervention

Transradial intervention usually does not mandate history of arm or forearm injury; we report a case of traumatic AV fistula with focal narrowing of brachial artery for which right transradial angiogram could not be performed and coronary angiogram was accomplished from left transradial access. This rare case teaches us the fact that planning a transradial intervention also requires a history of trauma or surgical intervention to arm or forearm to avoid inadvertent complications during transradial access. Communication between an artery and a vein is known as arteriovenous fistula (AVF) which may be congenital, acquired or surgically created. Acquired arteriovenous fistula is most commonly due to traumatic injury. Following vascular injury, a hematoma develops locally, local healing and fibrosis leads to adhesion between artery and vein creating an arteriovenous fistula.1 Large arteriovenous fistula results in high output cardiac failure and rarely accounts for chronic ischaemia.2 Degree of arteriovenous shunting decides the timeframe of clinical presentation which is often subtle with delay in diagnosis. We report a case of post traumatic brachial AV fistula presenting with feeble pulse, difficult radial puncture and right transradial access failure with switch over to right transfemoral access for accomplishing coronary intervention.

scholarly journals Successful Treatment of Hepatoportal Arteriovenous Fistula by Transcatheter Embolization with Steel Coils

1994 ◽  
Vol 8 (5) ◽  
pp. 313-316
Author(s):  
Taralyn D Picton ◽  
Lindsay Machan ◽  
Jennifer Davis ◽  
Hugh J Freeman ◽  
Urs P Steinbrecher
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Arteriovenous Fistula ◽  
Hepatic Artery ◽  
Successful Treatment ◽  
Variceal Bleeding ◽  
Transcatheter Embolization ◽  
Liver Trauma ◽  
Steel Coils ◽  
History Of

Portal hypertension is most commonly caused by increased intrahepatic resistance as a result of cirrhosis, but can also occur as a result of abnormally high portal bloodflow. This article describes a patient with a history of remote liver trauma in whom portal hypertension and variceal bleeding were shown to be due to an arteriovenous fistula between the hepatic artery and portal vein. Transcatheter embolization with Gianturco coils resulted in obliteration of the fistula and normalization of portal pressures.

scholarly journals Efficacy of intra-arterial indocyanine green angiography for the microsurgical treatment of dural arteriovenous fistula: A case report

2020 ◽  
Vol 11 ◽  
pp. 46
Author(s):  
Keisuke Sasaki ◽  
Hidenori Endo ◽  
Kuniyasu Niizuma ◽  
Yasuo Nishijima ◽  
Shinichiro Osawa ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Transverse Sinus ◽  
Vascular Lesions ◽  
Occipital Artery ◽  
Feeding Artery ◽  
Cortical Vein ◽  
History Of

Background: In this study, we report a case of dural arteriovenous fistula (dAVF) that was successfully treated using intra-arterial indocyanine green (IA-ICG) videoangiography during open surgery. Moreover, the findings of IA-ICG videoangiography were compared with those of intraoperative digital subtraction angiography (DSA). Case Description: A 72-year-old male patient with a history of hypertension, hyperlipidemia, and thrombocytosis presented with generalized seizure. DSA revealed Cognard Type III dAVF in the superior wall of the left transverse sinus, which was fed by a single artery (the left occipital artery [OA]) and drained into a single vein (the left temporal cortical vein), without drainage into a venous sinus. Since transarterial embolization was considered challenging due to the tortuosity of the left OA, surgical interruption of the shunt was performed by craniotomy. After excising the feeding artery, we were unable to observed dAVF on intraoperative DSA. However, IA-ICG videoangiography revealed the remaining shunt, which was fed by the collateral route from the feeding artery. The shunting point and draining vein were then surgically resected to eliminate the shunt. The shunt was not observed during the second IA-ICG videoangiography conducted after resection. Conclusion: ICG videoangiography is a better method compared with DSA in terms of visualizing fine vascular lesions. In contrast to the typical intravenous administration, selective IA-ICG can be repeatedly injected at a minimal dose. IA-ICG is a useful intraoperative tool that can be used to evaluate the elimination of the dAVF.

scholarly journals A Case of Superficial Femoral Arteriovenous Fistula and Severe Venous Stasis Ulceration, Managed with an Iliac Extender Prosthesis

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Nicole Ilonzo ◽  
Selena Goss ◽  
Chun Yang ◽  
Michael Dudkiewicz
Keyword(s):  
Heart Failure ◽  
Arteriovenous Fistula ◽  
Endovascular Repair ◽  
Gunshot Wound ◽  
Venous Insufficiency ◽  
Venous Stasis ◽  
Arteriovenous Fistulas ◽  
History Of ◽  
Surgical Options ◽  
Steal Syndrome

Most femoral artery arteriovenous fistulas occur as a result of percutaneous interventions. However, arteriovenous fistulas can occur in the setting of trauma, with resultant consequences such as heart failure, steal syndrome, or venous insufficiency. Indications for endovascular repair in this setting are limited to patients who are at too high risk for anesthesia, have a hostile groin, or would not survive significant bleeding. We report the case of a traumatic femoral arteriovenous fistula, causing severe venous insufficiency and arteriomegaly, in a 58-year-old male, with history of traumatic gunshot wound complicated by popliteal DVT. Surgical options for arteriovenous fistula include open and endovascular repair but this patient’s fistula was more suitable for endovascular repair for reasons that will be discussed.

Clinical Problem-Solving: Aneurysm or Spinal Arteriovenous Fistula—Bait and Switch

Neurosurgery ◽  
2011 ◽  
Vol 68 (3) ◽  
pp. E866-E873 ◽  
Author(s):  
Jeffrey F Lastfogel ◽  
Bernard R Bendok ◽  
Nicholas M Boulis ◽  
Aaron A Cohen-Gadol
Keyword(s):  
Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Artery Aneurysm ◽  
Clinical Problem ◽  
Anterior Communicating Artery ◽  
Clinical Problem Solving ◽  
Spinal Arteriovenous Fistula ◽  
Critical Issues ◽  
History Of ◽  
Instructive Case

Abstract OBJECTIVE: The authors use an instructive case to review the challenges of diagnosis in subarachnoid hemorrhage (SAH) and to reinforce the nuances of clinical management. IMPORTANCE: The presented case highlights critical issues in patient selection and challenges in the diagnosis of SAH and the management of both aneurysmal and arteriovenous fistula-related SAH. The critical points in decision making and diagnosis are discussed, and the case is accompanied by a brief review of the literature on the issues being faced. CLINICAL PRESENTATION: The present case is a patient presenting with SAH who was found to have an anterior communicating artery aneurysm. However, clues in the presentation and workup point to another etiology. CONCLUSION: A strong history of sudden neck pain before headache and abundance of SAH along the brainstem mandates a need to thoroughly evaluate the source of hemorrhage from cervical vessels through an angiogram.

Percutaneous embolization of renal arteriovenous fistula

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 207-210 ◽  
Author(s):  
Sendi ◽  
Toia ◽  
Nussbaumer
Keyword(s):  
Heart Failure ◽  
Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Abdominal Discomfort ◽  
Renal Arteriovenous Fistula ◽  
Percutaneous Embolization ◽  
Arterial Access ◽  
Number Of Publications ◽  
Occluding Balloon

Acquired renal arteriovenous fistula is a rare complication following a nephrectomy and its diagnosis may be made many years after the intervention. The closure of the fistula is advisable in most cases, since it represents a risk for heart failure and rupture of the vessel. There are an increasing number of publications describing different techniques of occlusion. The case of a 70-year-old woman with abdominal discomfort due to a large renal arteriovenous fistula, 45 years after nephrectomy, is presented and current literature is reviewed. Percutaneous embolization was performed by placing an occluding balloon through the draining vein followed by the release of nine coils through arterial access. One day after successful occlusion of the fistula, clinical symptoms disappeared.

An unusual presentation of epigastric pain due to thrombophlebitis of a recanalised umbilical vein – case report

2019 ◽  
Vol 98 (8) ◽  
pp. 326-327 ◽  
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Epigastric Pain ◽  
Umbilical Vein ◽  
History Of ◽  
Clinically Significant ◽  
Inflammatory Changes

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.

Sign in / Sign up

Export Citation Format

Share Document