Intrahepatic arterial-portal fistulas are well known and are usually secondary to trauma on liver biopsy. CASE REPORTSCase 2.-A 74-year-old woman was seen because of intermittent episodes of dysarthria for 6 years. DISCUSSIONOur review of the literature mevealed documentation of only three cases of pontahepatic venous fistulassimilar to the two reported here; none of the three were evaluated using US (1-3). Diabetes blood sugar levels chart: what is a normal blood, Keep in mind that the blood glucose level before a meal for a non diabetic person and a person with prediabetes may be very similar.
Blood glucose levels : testing and normal range, A blood glucose test measures the amount of a type of sugar, called glucose, in your blood.
Blood sugar – wikipedia, the free encyclopedia, The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in the blood of a human or animal. When your “normal” blood sugar isn’t normal (part 1), In the next two articles we’re going to discuss the concept of “normal” blood sugar. Blood pressure chart – normal blood pressure range, What is your adult blood pressure? Symptoms of high blood sugar-topic overview, High blood sugar (hyperglycemia) is most often seen in people who have diabetes that isn’t well controlled. Home « blood sugar basics, Make your next conversation with your diabetes healthcare team count by asking these quick questions about blood sugar!. Conversely, portahepatic fistulas are name and seem to be congenital; only three cases have been reported in the literature, to our knowledge.


Duning surgery, pressures in the right and left portal veins were normal (6-10mmHg); the pressure in the right pontal vein increased slightly (16-21 mmHg) after temporary occlusion of the left portal vein, its infenolatenal segmental branch, or even the left hepatic vein. 5) demonstrated a complex of branched venous channels within the posterior segment of the night lobe of the liver; this malformation communicated with the right portal vein and with a night accessory hepatic vein that joined the inferior vena cava under the confluence of the three hepatic veins. Physical examination showed bilateral cere-bellar and pyramidal tract signs, with astenixis but no hepatosplenomegaly. Transverse sonograms demonstrate biloculate aneurysm (a) in thelateral segment of the left hepatic lobe.
Celio-mesentenic angiognaphy shows dilatation of the hepatic anteryand its tortuous branches (a); in the venous phase (b), the dilated left portal vein(single arrow) feeds the fistula, which also communicates with the dilated left hepaticvein (double arrows). The surgeon considered the portal pressure increase moderate andresected the lateral segments of the left hepatic lobe. Pediatric portacaval shunts, which are always associated with many other malformations, have also been described. Venous blood ammonia was elevated fivefold; laboratory test results were otherwise negative on normal.
It communicates with the left portal vein (singlearrow) and the left hepatic vein (double arrows) (b).
Finally, various articleshave been published on the intrahepatic or extrahepatic venous malfommations (2, 5-7).
Injection of contrastmedium in the accessory hepatic vein opacified the venous malformation, the night hepatic vein, and the inferior vena cava.


We have identified the common patterns between our two cases and the three we have found in the literature(1-3).
Celio-mesentenic angiognaphy (Fig.2a, 2b) confirmed these findings and also showed poor opacification of theright portal vein.
The postoperative outcome included an episode of encephalopathy witha grade 1-2 coma; our patient recovened from the encephalopathy in 15 days and her serum ammonia levelsreturned to normal and EEC abnonmalities improved. 7) demonstnated the night portal vein feeding the malformation, which flowed into the accessory and the night hepatic veins. Percutaneous aneurysmal occlusion using a 27-mm balloonat the junction of the fistula and the left hepatic vein was unsuccessful because of the great size of the malfonmation; contrast medium injected through this balloon still reached the dilated hepatic vein. Neither a balloon non a coil was released in the fistula because of the high possibility of dislodgmenttoward the inferior venacava. The physical examination was normal, and there were no neunologic signs, abdominal bruits, on signs of encephalopathy.



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