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Congenital portosystemic shunts with and without gastrointestinal bleeding – case series

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Abstract

Background

The clinical presentation of congenital portosystemic shunt is variable and gastrointestinal bleeding is an uncommon presentation.

Objective

To describe the imaging features of congenital portosystemic shunt as it presented in 11 children with (n = 6) and without gastrointestinal bleeding (n = 5).

Materials and methods

We performed a retrospective study on a clinical and imaging dataset of 11 children diagnosed with congenital portosystemic shunt.

Results

A total of 11 children with congenital portosystemic shunt were included in this study, 7 with extrahepatic portosystemic shunts and 4 with intrahepatic portosystemic shunts. Six patients with gastrointestinal bleeding had an extrahepatic portosystemic shunt, and the imaging results showed that the shunts originated from the splenomesenteric junction (n = 5) or splenic vein (n = 1) and connected to the internal iliac vein. Among the five cases of congenital portosystemic shunt without gastrointestinal bleeding, one case was an extrahepatic portosystemic shunt and the other four were intrahepatic portosystemic shunts.

Conclusion

Most congenital portosystemic shunt patients with gastrointestinal bleeding had a shunt that drained portal blood into the iliac vein via an inferior mesenteric vein. This type of shunt was uncommon, but the concomitant rate of gastrointestinal bleeding with this type of shunt was high.

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Acknowledgments

This work was supported by the Medical Guide Project, Shanghai Committee of Science and Technology, China (Grant No. 134119a4100 to Z. Qiao), and the National Key Clinical Specialty Construction Programs of China (2014-2016).

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Radiology, Children’s Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China

    Ying Gong, Jun Chen, Qi Chen, Min Ji, Mier Pa & Zhongwei Qiao

  2. Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, the People’s Republic of China

    Hui Zhu

  3. Department of Surgery, Children’s Hospital of Fudan University, Shanghai, 200032, the People’s Republic of China

    Shan Zheng

Authors
  1. Ying Gong
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  2. Hui Zhu
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  3. Jun Chen
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  4. Qi Chen
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  5. Min Ji
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  6. Mier Pa
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  7. Shan Zheng
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  8. Zhongwei Qiao
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Corresponding author

Correspondence to Zhongwei Qiao.

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Gong, Y., Zhu, H., Chen, J. et al. Congenital portosystemic shunts with and without gastrointestinal bleeding – case series. Pediatr Radiol 45, 1964–1971 (2015). https://doi.org/10.1007/s00247-015-3417-6

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  • DOI: https://doi.org/10.1007/s00247-015-3417-6

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