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Hepatoportal arteriovenous fistula and portal hypertension in an infant.

Hepatic vascular lesions are rare, particularly in children. Hemangioendotheliomas frequently cause congestive heart failure secondary to systemic arteriovenous shunting of blood, whereas fistulas between the hepatic artery and portal vein usually produce portal hypertension and its complications. We report the fourth, and youngest, child with hepatoportal arteriovenous fistula (AVF). The clinical presentation of acute portal hypertension mimicking intestinal obstruction is unique.
 CASE REPORT
 A 5-week-old, 3.7-kg girl was admitted to Yale-New Haven Hospital with a one-week history of vomiting, diarrhea, and abdominal distention. Pregnancy and delivery had been uncomplicated. Findings of the physical examination were normal except for the abdomen which was distended and tympanitic, with high-pitched bowel sounds.