Simultaneous embolization of a spontaneous porto-systemic shunt and intrahepatic arterioportal fistula: A case report

Figure 1 Contrast-enhanced abdominal computed tomography. A: Computed tomography (CT) revealing early visualization of the portal vein (arrow) in the arterial phase; B: CT showing a large shunt (arrow) between the superior mesenteric vein and inferior vena cava; C: Three-dimensional vascular reconstruction demonstrating an intrahepatic arterioportal fistula (arrow); D: Three-dimensional vascular reconstruction revealing a large spontaneous portosystemic shunt (arrow) beside the left kidney (asterisk).

Figure 2 Selective angiography of the common hepatic artery and portal trunk. A: Selective digital subtraction angiography of the common hepatic artery revealing rapid filling through the fistula (arrow) into the left branch of the portal vein; B: The fistula was abrogated after embolization with stainless metal coils; C: Selective angiography of the portal trunk showing the large shunt between the superior mesenteric vein and inferior vena cava (arrow); D: Selective angiography of the portal trunk demonstrating that the opacification of the shunt had markedly decreased (arrow) after embolization.