Portal Vein Hypoplasia and Patent Ductus Venosus

Abstract

Patent ductus venosus and congenital portosystemic shunt with or without hypoplasia of portal vein can be diagnosed by US study before or after birth. Congenital hypoplasia of portal vein includes the type with hypoplastic intrahepatic portal system (type II) and the type with complete agenesis (type I). Differentiation of the types is important for the indication of the following treatment. Direct imaging of the portal vein via mesenteric venous branches through small laparotomy or percutaneous transhepatic puncture should be done. If the interventional radiology is not successful for the closure of the shunt or ductus venosus, surgical intervention should be considered.

The patent ductus venosus runs along the groove between the caudate lobe and left lateral segment. The duct near the left hepatic vein can be encircled and ligated. After surgical closure of such congenital portosytemic shunts, portal vein thrombosis and portal vein congestion should be expected as complications. If there are serious complications, release of the closure should be done.

The figures in this chapter are reprinted with permission from Standard Pediatric Operative Surgery (in Japanese), Medical View Co., Ltd., 2013, with the exception of occasional newly added figures that may appear.