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Traumatic hepatic artery portal vein arteriovenous fistulae (HPF) are uncommon but potentially life-threatening distortions of hepatic circulation. They are curable causes of gastrointestinal bleeding and portal hypertension. HPF may result from lacerations of adjacent arterial and venous walls, pseudoaneurysms, or liver erosion causing a shunt into the portal vein. Symptoms are GI bleeding, or crampy abdominal pain and diarrhea, or in delayed HPF, signs of portal hypertension. Angiography can make the diagnosis and may be therapeutic, as in one reported case, in which successful transcatheter embolization obviated the need for surgical treatment.
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