A case of ascites and SMV thrombosis dueto an intrahepatic arterio-portal fistula after hepatectomy

Arterio-portal fistula (APF) is a rare vascular abnormality, characterized by communication between artery and portal vein. We describe a 69-year-old male patient with APF, who developed acute clinical symptoms 10 months after hepatectomy. The APF was accompanied by massive ascites and thrombosis in the superior mesenteric vein. The condition was successfully treated using anticoagulant, diuretics, and interventional coil embolization of the fistulas. This case indicates that APF is an important postoperative complication after hepatectomy, and that intrahepatic APFs could manifest acutely with ascites and superior mesenteric vein thrombosis.