Hepatocellular carcinoma and arterio-portal fistula

Case contributed by Ahmed Abdrabou
Diagnosis certain


Abdominal pain, dyspepsia and progressive distension

Patient Data

Age: 65 years
Gender: Male

Multifocal hepatocellular carcinomas involve hepatic subsegments VIII and IVa and display typical enhancing criteria, early arterial enhancement followed by rapid washout in portovenous phase.

Early filling of the right and left portal branches is seen in the arterial phase due to an arterio-portal shunt involving the right portal vein branch.

Hepatic cirrhotic changes, splenomegaly, portal hypertension, small bowel congestion, calcular gall bladder and ascites are also noted.

Case Discussion

Intrahepatic arterio-portal shunt can occur as a complication of hepatocellular carcinoma (tumorous shunt) or non-tumorous in case of hepatic intervention.

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