A fistula is an unnatural opening between two structures. In this case, a fistula has formed between two liver vessels: an artery and a branch of the portal vein. The fluoroscopy image shows dye injected into the artery leaking into the portal vein branch.
The painting accurately reflects the vessels seen in the fluoroscopy, including this patient’s variant anatomy: a right replaced hepatic artery arising from the superior mesenteric artery.