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A rare congenital extrahepatic portosystemic shunt affecting the inferior mesenteric vein, inferior vena cava, and left ovarian vein

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Abstract

Purpose

To observe a case of congenital extrahepatic portosystemic shunt and discuss it from the embryological and clinical viewpoints.

Methods

An 85-year-old female cadaver was employed for a dissection course at Aichi Medical University in 2009.

Results

There was no evidence of liver cirrhosis macroscopically or microscopically. A portosystemic shunt was observed that involved communication between the inferior mesenteric vein, inferior vena cava (IVC), and left ovarian vein by a single Y-shaped shunt vessel.

Conclusions

To the best of our knowledge, this is the first reported case of the above-mentioned three veins being connected by a single Y-shaped shunt vessel. Considering the other venous diameters, the shunt appeared to flow into the splenic vein and IVC. It cannot be denied that this shunt may have led to hepatic encephalopathy, although the shunt effect may have been minimal. Embryological development of IVC appears to occur close to the plexus of anastomosing vitelline veins, forming the portal vein.

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References

  1. Abernethy J (1793) Account of two instances of uncommon formation, in the viscera of the human body. Philos Trans R Soc Lond B Biol Sci 83:59–66

    Article  Google Scholar 

  2. Bernard O, Franchi-Abella S, Branchereau S, Pariente D, Gauthier F, Jacquemin E (2012) Congenital portosystemic shunt in children: recognition, evaluation, and management. Semin Liver Dis 32:273–287

    Article  CAS  PubMed  Google Scholar 

  3. Gitzelmann R, Forster I, Willi UV (1997) Hypergalactosaemia in a newborn: self-limiting intrahepatic portosystemic venous shunt. Eur J Pediatr 156:719–722

    Article  CAS  PubMed  Google Scholar 

  4. Hamilton WJ, Mossman HW (1972) Hamilton, Boyd and Mossman’s Human embryology: prenatal development of form and function. Heffer, Cambridge, pp 278–279

    Google Scholar 

  5. Kobayashi N, Niwa T, Kirikoshi H, Fujita K, Yoneda M, Saito S, Nakajima A (2010) Clinical classification of congenital extrahepatic portosystemic shunts. Hepatol Res 40:585–593

    Article  PubMed  Google Scholar 

  6. Moore KL, Persaud TVN (2011) The developing human, clinically oriented embryology, 9th edn. WB Saunders, Philadelphia, pp 290–293

    Google Scholar 

  7. Morgan G, Superina R (1994) Congenital absence of the portal vein: two cases and a proposed classification system for portasystemic vascular anomalies. J Pediatr Surg 29:1239–1241

    Article  CAS  PubMed  Google Scholar 

  8. Nishimoto Y, Hoshino H, Sato S, Oguri A, Yamada M, Nishimura D, Katada N, Sano H, Kato K (1997) Extrahepatic portosystemic venous shunt without portal hypertension. Intern Med 36:886–889

    Article  CAS  PubMed  Google Scholar 

  9. Ohwada S, Hamada Y, Morishita Y, Tanahashi Y, Takeyoshi I, Kawashima Y, Nakamura S, Iino Y, Miyamoto Y, Hirato J (1994) Hepatic encephalopathy due to congenital splenorenal shunts: report of a case. Surg Today 24:145–149

    Article  CAS  PubMed  Google Scholar 

  10. Stringer MD (2008) The clinical anatomy of congenital portosystemic venous shunts. Clin Anat 21:147–157

    Article  PubMed  Google Scholar 

  11. Takashi M, Takayasu K, Koen H (1980) Percutaneous transhepatic portography IV. Extrahepatic porta-systemic shunt and its clinical significance in portal hypertension. Acta Hepatol Japon 21:857–865 (in Japanese with English abstract)

    Article  Google Scholar 

  12. Tanaka R, Ibukuro K, Abe S, Tobe K, Fukuda H, Kondou Y, Tagawa K (2009) Treatment of hepatic encephalopathy due to inferior mesenteric vein/inferior vena cava and gonadal vein shunt using dual balloon-occluded retrograde transvenous obliteration. Cardiovasc Intervent Radiol 32:390–393

    Article  PubMed  Google Scholar 

  13. Uchino T, Matsuda I, Endo F (1999) The long-term prognosis of congenital portosystemic venous shunt. J Pediatr 135:254–256

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors wish to thank Dr. Ken Asamoto, Dr. Keiichi Ohta, Dr. Yusuke Ohmichi, and Dr. Munekazu Naito for their constructive suggestions and comments. This work was supported by Aichi Medical University Aitachibana Association, grant number AMU-AARF-2010007.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. School of Medicine, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan

    Hajime Takeuchi, Yoko Takeda & Miyo Takahashi

  2. Department of Anatomy, Tokyo Medical University, Shinjuku, Tokyo, 160-8402, Japan

    Shogo Hayashi

  3. Medical Education Center, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan

    Yoshitaka Fukuzawa

  4. Department of Anatomy, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan

    Takashi Nakano

Authors
  1. Hajime Takeuchi
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  2. Yoko Takeda
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  3. Miyo Takahashi
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  4. Shogo Hayashi
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  5. Yoshitaka Fukuzawa
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  6. Takashi Nakano
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Corresponding author

Correspondence to Shogo Hayashi.

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Takeuchi, H., Takeda, Y., Takahashi, M. et al. A rare congenital extrahepatic portosystemic shunt affecting the inferior mesenteric vein, inferior vena cava, and left ovarian vein. Surg Radiol Anat 36, 729–732 (2014). https://doi.org/10.1007/s00276-013-1230-1

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  • DOI: https://doi.org/10.1007/s00276-013-1230-1

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