Abstract
A 70-year-old man who underwent pancreaticoduodenectomy and portal vein repair for advanced cholangiocarcinoma (T4N2M0 Stage IVb) six months ago was admitted because of anorexia and sudden onset of liver dysfunction. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated multiple liver tumors and portal hypertension, which was diagnosed as A-P shunt by angiography. Hepatic arterial embolization was attempted unsuccessfully because hepatic artery occlusion did not confirm portal vein flow to liver. His general condition was gradually worsened and he died of liver failure. Autopsy revealed A-P shunts due to liver metastases of the cholangiocarcinoma. A-P shunt by liver metastasis is very rare and we present a case of such a case with liver metastasis of cholangiocarcinoma together with literature review.
