Hepatic artery-portal vein fistula following blunt trauma

A 21-year-old man presented with a steering wheel injury. Angiography revealed an intrahepatic artery aneurysm. Ultrasonography revealed an intraparenchymal hematoma. Repeat angiography demonstrated a large hepatic artery-portal vein fistula. Laparotomy was performed, the fistula opened and all feeding vessels individually ligated. Follow-up angiogram, liver scan and ultrasonography showed absence of the fistula and parenchymal healing. Hepatic injuries following abdominal trauma are reviewed. The value of angiography in diagnosing hepatic injuries including hepatic artery aneurysms and hepatic artery-portal vein fistulas is stressed.