A 54-yr-old male with portal hypertension received ineffective medical therapy for the diagnosis of portal hepatic cirrhosis. Duplex ultrasound (US) revealed pulsatile arterial flow in the right main portal vein. The correct diagnosis of intrahepatic arterioportal fistula was established and confirmed by angiography. Right hepatic artery embolization with three coils was performed. The patient is alive for 16 months after the embolization, and his complaints have disappeared. There has been full resorption of ascites and absence of varices. Nine previously reported similar cases are reviewed.

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