CASE REPORT article
Front. Med.
Sec. Hepatobiliary Diseases
Intrahepatic arterioportal fistula (IAPF) -A Rare Cause of Hemobilia
Yanbian University Hospital, Yanji, China
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Abstract
Intrahepatic arterioportal fistula is a rare vascular malformation, and cases of hemobilia due to it are extremely rare. This article reports a rare case of hemobilia due to Intrahepatic arterioportal fistula in an elderly woman. Upon admission, the patient presented with sporadic upper abdominal pain lasting three days. The initial diagnosis of choledocholithiasis was made following a review of the upper abdominal Computed Tomography（CT）scan from a previous hospital and our hospital's Magnetic Resonance Cholangiopancreatography（MRCP）. Hemobilia and sedimentary clot were identified during ERCP microscopy. Post-ERCP imaging, specifically CT enhancement, revealed an intrahepatic arterioportal fistula. This finding, in conjunction with insights from a multidisciplinary consultation, led to treatment via transcatheter arterial embolization (TAE). The patient recovered well postoperatively with cessation of bleeding. This case demonstrates IAPF as a rare cause of biliary bleeding and the diagnostic value of imaging for IAPF, which provides reference for the diagnosis and treatment of complex biliary diseases in elderly patients.
Summary
Keywords
case report, ERCP, Hemobilia, Intrahepatic arterioportal fistula, Transcatheterarterial embolization
Received
29 December 2025
Accepted
05 February 2026
Copyright
© 2026 Wang, Jiang, Jin and Jin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Xu Jiang; lin Xing Jin
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