One of the most hazardous types of bleeding from the gastrointestinal tract is that occurring from esophageal or gastric varices. Such varices usually arise following an obstruction to the return of portal blood to the systemic venous system. There are two common types of portal obstruction: that occurring in the liver—the so-called intrahepatic type—and that seen in splenomegaly (Banti's syndrome), in which the portal vein is obstructed. The latter is referred to as the extrahepatic type. In addition Linton has described portal hypertension occurring secondary to a combination of the above two lesions. We would like to suggest that the lesion presented by the patient in this report represents an additional situation in which portal hypertension may develop, i. e., secondary to an arteriovenous fistula between the hepatic artery and portal vein. This case is the second to be recorded in the literature. The first was reported by Strickler, Lufkin,