Hyperkinetic portal hypertension. Arterioportal fistula: problems--case reports--review of the literature

Hyperkinetic portal hypertension is caused by pathological arterioportal shunts. Clinical differentiation is necessary between extrahepatic fistulas, splenoportal hypertension (arteriovenous anastomoses at the level of the pre-penicilary arteries) and intrahepatic fistulas in "active" cirrhosis and malignant tumors. This paper reports the clinical and angiographic features of eight patients with this type of fistula. A review of the literature is also presented (144 cases). Because of the severity of this disease, surgical intervention is necessary. The surgical technique depends on the organ-related necessity of vascular preservation.