Intrahepatic portosystemic venous shunt

Case contributed by Dr Bob Zhang

Presentation

Unwitnessed fall from supported accommodation. Trauma scan.

Patient Data

Age: 90 years
Gender: Female

There is a tortuous and dilated right portal vein in segment 6 liver with aneurysmal communication to the right hepatic vein, which has aberrant drainage into the IVC distal to the left and middle hepatic veins

There are dilated intrahepatic and common bile ducts measuring up to 1.5 cm in diameter. The main pancreatic duct is dilated at the head, measuring 10 mm in diameter, however the rest of the pancreatic duct is non-dilated. The gallbladder is absent, pancreas appears normal, and there is no evidence of an obstructing mass lesion.

Case Discussion

Intrahepatic portosystemic venous shunts between a portal vein and a hepatic vein are rare. In this case, there is a communication between the right portal vein and the right hepatic vein, which drains aberrantly into the IVC. There is no known history of cirrhosis or liver trauma so they cause is presumed to be congenital. 

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Case information

rID: 69021
Published: 25th Jun 2019
Last edited: 17th Aug 2019
Inclusion in quiz mode: Included
Institution: Alfred Health

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