Intrahepatic arterioportal shunt

Last revised by Arlene Campos on 13 Dec 2023

Intrahepatic arterioportal shunts, also known as arterioportal fistulas, represent abnormal flow between the portal venous system and a hepatic arterial system within the liver. They can be a reversible cause of portal hypertension.

Clinical features will depend on the size and other underlying pathology. Small shunts can be asymptomatic.  

Intrahepatic vascular shunts can be divided according to the cause into:

Sometimes arterioportal shunts appear in dynamic CT as enhancing nodules, which can mimic hepatocellular carcinoma. The best way to differentiate is by using MRI with SPIO (superparamagnetic iron oxide) which is deposited in hepatocellular carcinoma and washed out in vascular shunt.

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Cases and figures

  • Case 1: iatrogenic arterioportal fistula
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  • Case 2: hepatocellular carcinoma
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  • Case 3: hepatocellular carcinoma
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  • Case 4: diffuse hepatocellular carcinoma
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  • Case 5
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  • Case 6: hepatocellular carcinoma
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  • Case 7: shunt secondary to HCC through the transvasal route
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