Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.190136
Jornal Vascular Brasileiro
Therapeutic Challenge

Tratamento endovascular da hipertensão portal e da hemorragia digestiva recorrente e secundária à síndrome da fístula arterioportal: complicação tardia de trauma abdominal penetrante

Endovascular treatment of portal hypertension and recurrent digestive hemorrhage secondary to arterioportal fistula syndrome: late complication of penetrating abdominal trauma

Matheus Bertanha; Regina Moura; Rodrigo Gibin Jaldin; Marcone Lima Sobreira; Arthur Curtarelli; Felipe Damacena Rosa; Marcelo Sembenelli; Winston Bonetti Yoshida

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Resumo

Resumo: A síndrome da fístula artério-portal (FAP) é uma rara e reversível causa de hipertensão portal pré-sinusoidal, ocasionada pela comunicação de uma artéria visceral com o sistema venoso portal. A maioria dos pacientes é assintomática, mas quando desenvolvem sintomas, estes são mais relacionados com sangramento gastrointestinal, ascite, insuficiência cardíaca congestiva e diarreia. Este desafio terapêutico apresenta um caso de FAP decorrente de ferimento antigo por arma branca e subsequente evolução clínica desfavorável, com grave desnutrição e frequentes hemorragias digestivas. O caso foi solucionado através de oclusão da FAP por meio de tratamento endovascular.

Palavras-chave

fístula vascular, fístula arteriovenosa, hipertensão portal, ferimentos penetrantes, procedimentos endovasculares

Abstract

The arterioportal fistula (APF) syndrome is a rare and reversible cause of pre-sinusoidal portal hypertension, caused by communication between a visceral artery and the portal venous system. Most patients are asymptomatic, but when they do develop symptoms, these are mainly related to gastrointestinal bleeding, ascites, congestive heart failure, and diarrhea. This therapeutic challenge presents a case of APF caused by a 20-year-old stabbing injury with unfavorable late clinical evolution, including significant malnutrition and severe digestive hemorrhages. The patient was treated using an endovascular procedure to occlude of the fistula.

Keywords

vascular fistula; arteriovenous fistula; portal hypertension; penetrating wounds; endovascular procedures

References

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