Congenital extrahepatic portosystemic shunt

Case contributed by Elsayed Mohamed Elsayed Galbat
Diagnosis almost certain

Presentation

A case of cancer endometrium.

Patient Data

Age: 60 years
Gender: Female

A large vascular channel is seen draining the superior mesenteric vein coursing through the left side of the abdomen to into the IVC at renal veins level likely representing a congenital extrahepatic portosystemic shunt. Aortic origin of the common heptic artery.

The liver shows small left lobe with absent left portal vein. Small vascular channels are seen at the hepatic hilum replacing the normal anatomical appearance of the main portal vein.

Small cyst is seen in right para-cardiac region likely representing pleuro-pericardial cyst.

 

Case Discussion

These are rare vascular anomalies of the splanchnic venous system. Congenital portosystemic shunts result from the persistence of the embryonic vessels. 

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