48 Splenic Arteriovenous Fistula with Features of Portal Hypertension

Clinical Presentation

A 40-year-old man presents with abdominal pain and a single episode of an upper gastrointestinal (GI) bleed.

Fig. 48.1 (A) Contrast-enhanced axial CT image shows the presence of a splenic arteriovenous fistula (arrow). (B) Note the dilated upper abdominal venous varices (arrows).

Contrast-enhanced axial computed tomography (CT) scans (Fig. 48.1) show an enlarged spleen with an arteriovenous (AV) fistula and early opacification of the splenic vein. Note the enlarged collateral veins in the upper abdomen.