Intrahepatic portosystemic venous shunt
Unwitnessed fall from supported accommodation. Trauma scan.
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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.
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.