Hepatocellular carcinoma and arterio-portal fistula
Abdominal pain, dyspepsia and progressive distension
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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 are seen in arterial phase due to an arterio-portal shunt involves the right portal vein branch. Hepatic cirrhotic changes, splenomegaly, portal hypertension, small bowel congestion, calcular gall bladder and ascites are also noted.