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Intrahepatic portosystemic venous shunt

Case contributed by Matthew Lukies
Diagnosis certain

Presentation

Presented with vague abdominal pain, but was pain free by the time of the follow up CT study.

Patient Data

Age: 80 years
Gender: Male
ultrasound

A tortuous and dilated vessel at the superior aspect of the right hepatic lobe appears to communicate with both the right portal vein and hepatic vein.

  • tortuous right portal vein with an aneurysmal communication to the right hepatic vein in segment 7 of the liver, consistent with an intra-hepatic portosystemic venous shunt

  • prominent main portal vein

  • no evidence of portal vein thrombosis

  • no evidence of cirrhosis or portal vein cavernous transformation

  • cholelithiasis

  • prostatomegaly, sigmoid diverticulosis

Case Discussion

The patient in this case had no evidence of cirrhosis, or history of biopsy/surgery in the right lobe of the liver, indicating that the intrahepatic portosystemic venous shunt is most likely congenital.

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