Pediatric Surgery International

, Volume 26, Issue 10, pp 1025–1030 | Cite as

Surgical intervention for patent ductus venosus

  • Arata Kamimatsuse
  • Yoshiyuki Onitake
  • Naomi Kamei
  • Go Tajima
  • Nobuo Sakura
  • Taijiro Sueda
  • Eiso HiyamaEmail author
Original Article


Patent ductus venosus (PDV) is a rare condition, which usually presents secondary to hepatic atrophy and hepatic failure. We have treated eight cases of PDV, all with hypergalactosemia and hyperbilirubinemia. Ultrasonography and three-dimensional computed tomography demonstrated communication between the portal vein and the inferior vena cava. Of the eight PDV cases, three from the older age group (ages 9, 11, and 14 years) had high-density lesions in their brain nucleus, and one case (age 19 years) had undergone prior Kasai portoenterostomy for biliary atresia. Six PDV patients underwent ligation of PDV and the remaining two cases underwent partial banding of PDV with intraoperative monitoring to maintain portal vein pressure (PVP) under 30 cm H2O. Improvement of the intrahepatic portal vein flow was achieved by ligation or banding of PDV. Postoperatively, serum galactose and bilirubin fell to normal ranges, but portal thrombus occurred postoperatively in the first case. We subsequently administered postoperative anticoagulation in the remaining cases and experienced no major complications. These results suggest that PDV ligation and banding are effective surgical approaches for patients with PDV. Close postoperative monitoring to avoid portal thrombus is imperative in these cases.


Patent ductus venosus Surgery Ligation Banding Portal thrombosis 


  1. 1.
    Stringer MD (2008) The clinical anatomy of congenital portosystemic venous shunts. Clin Anat 21(2):147–157CrossRefPubMedGoogle Scholar
  2. 2.
    Yoshimoto Y, Shimizu R, Saeki T, Harada T, Sugio Y, Nomura S, Tanaka H (2004) Patent ductus venosus in children: a case report and review of the literature. J Pediatr Surg 39(1):E1–E5CrossRefPubMedGoogle Scholar
  3. 3.
    Murray CP, Yoo SJ, Babyn PS (2003) Congenital extrahepatic portosystemic shunts. Pediatr Radiol 33(9):614–620CrossRefPubMedGoogle Scholar
  4. 4.
    Ikeda S, Yamaguchi Y, Sera Y, Ohshiro H, Uchino S, Ogawa M (1999) Surgical correction of patent ductus venosus in three brothers. Dig Dis Sci 44(3):582–589CrossRefPubMedGoogle Scholar
  5. 5.
    Uchino T, Matsuda I, Endo F (1999) The long-term prognosis of congenital portosystemic venous shunt. J Pediatr 135(2 Pt 1):254–256PubMedGoogle Scholar
  6. 6.
    Yagi H, Takada Y, Fujimoto Y, Ogura Y, Kozaki K, Ueda M, Tanaka K (2004) Successful surgical ligation under intraoperative portal vein pressure monitoring of a large portosystemic shunt presenting as an intrapulmonary shunt: report of a case. Surg Today 34(12):1049–1052CrossRefPubMedGoogle Scholar
  7. 7.
    Loberant N, Barak M, Gaitini D, Herskovits M, Ben-Elisha M, Roguin N (1992) Closure of the ductus venosus in neonates: findings on real-time gray-scale, color-flow Doppler, and duplex Doppler sonography. AJR Am J Roentgenol 159(5):1083–1085PubMedGoogle Scholar
  8. 8.
    Fugelseth D, Lindemann R, Liestol K, Kiserud T, Langslet A (1997) Ultrasonographic study of ductus venosus in healthy neonates. Arch Dis Child Fetal Neonatal Ed 77(2):F131–F134CrossRefPubMedGoogle Scholar
  9. 9.
    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(9):1239–1241CrossRefPubMedGoogle Scholar
  10. 10.
    Howard ER, Davenport M (1997) Congenital extrahepatic portocaval shunts—the Abernethy malformation. J Pediatr Surg 32(3):494–497CrossRefPubMedGoogle Scholar
  11. 11.
    Jacob S, Farr G, De Vun D, Takiff H, Mason A (1999) Hepatic manifestations of familial patent ductus venosus in adults. Gut 45(3):442–445CrossRefPubMedGoogle Scholar
  12. 12.
    Uchino T, Endo F, Ikeda S, Shiraki K, Sera Y, Matsuda I (1996) Three brothers with progressive hepatic dysfunction and severe hepatic steatosis due to a patent ductus venosus. Gastroenterology 110(6):1964–1968CrossRefPubMedGoogle Scholar
  13. 13.
    Nakasaki H, Tanaka Y, Ohta M, Kanemoto T, Mitomi T, Iwata Y, Ozawa A (1989) Congenital absence of the portal vein. Ann Surg 210(2):190–193CrossRefPubMedGoogle Scholar
  14. 14.
    Arana E, Marti-Bonmati L, Martinez V, Hoyos M, Montes H (1997) Portal vein absence and nodular regenerative hyperplasia of the liver with giant inferior mesenteric vein. Abdom Imaging 22(5):506–508CrossRefPubMedGoogle Scholar
  15. 15.
    Joyce AD, Howard ER (1988) Rare congenital anomaly of the portal vein. Br J Surg 75(10):1038–1039CrossRefPubMedGoogle Scholar
  16. 16.
    Barton JW 3rd, Keller MS (1989) Liver transplantation for hepatoblastoma in a child with congenital absence of the portal vein. Pediatr Radiol 20(1–2):113–114CrossRefPubMedGoogle Scholar
  17. 17.
    Starzl TE, Francavilla A, Halgrimson CG, Francavilla FR, Porter KA, Brown TH, Putnam CW (1973) The origin, hormonal nature, and action of hepatotrophic substances in portal venous blood. Surg Gynecol Obstet 137(2):179–199PubMedGoogle Scholar
  18. 18.
    Vonnahme FJ, Dubuisson L, Kubale R, Klempnauer R, Grun M (1984) Ultrastructural characteristics of hyperplastic alterations in the liver of congenital portacaval-shunt rats. Br J Exp Pathol 65(5):585–596PubMedGoogle Scholar
  19. 19.
    Bioulac-Sage P, Saric J, Boussarie L, Balabaud C (1985) Congenital portacaval shunt in rats: liver adaptation to lack of portal vein—a light and electron microscopic study. Hepatology 5(6):1183–1189CrossRefPubMedGoogle Scholar
  20. 20.
    Matsubara T, Sumazaki R, Saitoh H, Imai H, Nakayama J, Takita H (1996) Patent ductus venosus associated with tumor-like lesions of the liver in a young girl. J Pediatr Gastroenterol Nutr 22(1):107–111CrossRefPubMedGoogle Scholar
  21. 21.
    Egawa H, Kasahara M, Inomata Y, Uemoto S, Asonuma K, Fujita S, Kiuchi T, Hayashi M, Yonemura T, Yoshibayashi M, Adachi Y, Shapiro JA, Tanaka K (1999) Long-term outcome of living related liver transplantation for patients with intrapulmonary shunting and strategy for complications. Transplantation 67(5):712–717CrossRefPubMedGoogle Scholar
  22. 22.
    Charre L, Roggen F, Lemaire J, Mathijs J, Goffette P, Danse E, Lerut J (2004) Hematochezia and congenital extrahepatic portocaval shunt with absent portal vein: successful treatment by liver transplantation. Transplantation 78(9):1404–1406CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Arata Kamimatsuse
    • 1
  • Yoshiyuki Onitake
    • 1
  • Naomi Kamei
    • 1
  • Go Tajima
    • 2
  • Nobuo Sakura
    • 2
  • Taijiro Sueda
    • 1
  • Eiso Hiyama
    • 1
    Email author
  1. 1.Department of Pediatric Surgery, Graduate School of Biomedical Science, Natural Center for Basic Research and DevelopmentHiroshima UniversityHiroshimaJapan
  2. 2.Department of Pediatrics, Graduate School of Biomedical Science, Natural Center for Basic Research and DevelopmentHiroshima UniversityHiroshimaJapan

Personalised recommendations