Yan JY, Wang JY, Chen W, Hua R. Acute portal hypertension due to delayed post-splenectomy arteriovenous fistula: A case report. World J Gastrointest Surg 2026; 18(7): 119297 [DOI: 10.4240/wjgs.v18.i7.119297]
Corresponding Author of This Article
Rong Hua, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University, No. 160 Pujian Road, Shanghai 200127, China. 13611657722@sina.cn
Research Domain of This Article
Gastroenterology & Hepatology
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case-report
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Yan JY, Wang JY, Chen W, Hua R. Acute portal hypertension due to delayed post-splenectomy arteriovenous fistula: A case report. World J Gastrointest Surg 2026; 18(7): 119297 [DOI: 10.4240/wjgs.v18.i7.119297]
World J Gastrointest Surg. Jul 27, 2026; 18(7): 119297 Published online Jul 27, 2026. doi: 10.4240/wjgs.v18.i7.119297
Acute portal hypertension due to delayed post-splenectomy arteriovenous fistula: A case report
Jia-Yan Yan, Jia-Yi Wang, Wei Chen, Rong Hua
Jia-Yan Yan, Wei Chen, Rong Hua, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University, Shanghai 200127, China
Jia-Yan Yan, Department of Hepatobiliary Surgery and Liver Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Jia-Yi Wang, Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Wei Chen, Shanghai Key Laboratory of Biliary Tract Disease Research, State Key Laboratory of Oncogenes and Related Genes, Shanghai Research Center of Biliary Tract Disease, Shanghai 200127, China
Co-first authors: Jia-Yan Yan and Jia-Yi Wang.
Author contributions: Hua R contributed to conceptualization, methodology, project administration, supervision, and validation; Yan JY contributed to conceptualization, data curation, investigation, methodology, validation, visualization, and writing (original draft, review and editing); Wang JY contributed to conceptualization, validation, visualization, and writing (original draft, review and editing); Chen W contributed to conceptualization, supervision, and validation. Written consent for publication was obtained from the patient. Yan JY and Wang JY contributed equally to this work as co-first authors.
Informed consent statement: Informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Rong Hua, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University, No. 160 Pujian Road, Shanghai 200127, China. 13611657722@sina.cn
Received: January 27, 2026 Revised: March 1, 2026 Accepted: April 10, 2026 Published online: July 27, 2026 Processing time: 185 Days and 5.5 Hours
Abstract
BACKGROUND
Portal hypertension is typically associated with cirrhosis, but acute etiologies must be considered in atypical cases. Post-splenectomy arteriovenous fistula (AVF) is a rare vascular complication that can lead to acute portal hypertension with nonspecific symptoms.
CASE SUMMARY
A 43-year-old man presented with acute abdominal pain, hematemesis, and melena, eight years after open splenectomy. Computed tomography angiography revealed a splenic AVF. Emergency laparotomy with splenic artery ligation was performed. The patient recovered uneventfully and remained asymptomatic at five-year follow-up.
CONCLUSION
Splenic AVF should be considered in patients with new-onset portal hypertension, a history of splenectomy, and no liver disease. Prompt diagnosis and surgical intervention yield excellent outcomes.
Core Tip: A delayed splenic arteriovenous fistula can cause acute portal hypertension years after splenectomy. Computed tomography angiography confirms the diagnosis, and prompt surgical or endovascular intervention leads to full recovery.
