• Zhenyu Ge, Kai Wang, Zhaomei Zhang, Xiaoqian Zhang, Peng Sun, Ning Chen, Yang Tan, Tingting Shen, Hongsheng Dai, and Wenwen Li.
• Department Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang City, Shandong Province, China.
• Medicine (Baltimore). 2024 Jan 26; 103 (4): e36886e36886.

IntroductionHepatic artery-portal vein malformation is rarely encountered in clinical practice. Here, we reported a case of liver cirrhosis combined with hepatic artery-portal vein malformation with refractory ascites as the main symptom. And it was successfully treated by us. The present case demonstrates the role of hepatic artery-portal vein malformation in cirrhotic ascites and the importance of early diagnosis and interventional treatment. This article may provides some experience for the treatment of such patients.Patient ConcernsThe patient was a 72-year-old woman with a 40-year history of Hepatitis B virus surface antigen positivity who sought medical advice with a chief complaint of abdominal distension for 1 week.DiagnosesEnhanced abdominal computed tomography imaging of this patient revealed liver cirrhosis, splenomegaly, esophageal and gastric varices, massive ascites, and a low-density area in the S4 segment of the liver with an ambiguous boundary. Widening of the left branch of the portal vein was evident, and the portal vein was highlighted in the arterial phase and the venous phase. Digital subtraction angiography revealed substantial thickening of the left hepatic artery, and the administered contrast agent drained through the malformed vascular mass to the thickened left portal vein. Liver cirrhosis combined with hepatic artery-portal vein malformation were diagnosed. And we considered that the artery-portal vein malformation in this patient might be caused by cirrhosis.InterventionsThe patient was applied diuretics, entecavir and transcatheter embolization.OutcomesThe patient ascites did not resolve significantly when treated with diuretics alone. After the transcatheter embolization, the patient ascites relieved remarkably.ConclusionThe patient underwent transcatheter embolization for hepatic artery-portal vein malformation, after which her ascites resolved with good short-term curative efficacy. So, the patients who suffered from liver cirrhosis combined with hepatic artery-portal vein malformation and refractory ascites, should be active on transcatheter embolization.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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