Summary
Four cases of enormous shunt between portal and hepatic veins (portal-hepatic venous shunt) are reported with special reference to sonographic and portographic findings. Ultrasonography, an examination for screening, delineated a snail-like anechoic area in the liver, its connection with the portal and hepatic veins, and marked dilatation of the veins connecting with the shunt. Transarterial or percutaneous transhepatic portography, a method for definitive diagnosis, demonstrated large pooling of the contrast medium flowing from the dilated portal branch and subsequent visualization of the hepatic vein. The etiology and prognosis are unknown at present. The most likely pathogenesis for this shunt seemed to be a congenital anomaly, namely, persistence of the omphalomesenteric venous system. With recent advances in and the more frequent use of real-time ultrasonography, detection of this kind of vascular abnormality will doubtless increase.
Similar content being viewed by others
References
Popper H, et al: Vascular pattern of the cirrhotic liver. Am J Clin Path 1952, 22: 717
Horiguchi Y, et al: Two cases of intrahepatic portasystemic shunt. Acta Hepatol Jap 1984, 25: 794 (Jpn)
Takayasu K, et al: Spontaneous portal-hepatic venous shunt via an intrahepatic portal vein aneurysma. Gastroenterology 1984, 86: 945
Raskin NH, et al: Portal-systemic encephalopathy due to congenital intrahepatic shunts. N Engl J Med 1964, 270: 225
Kozuka S, et al: An enormous intrahepatic shunt between portal vein and hepatic one. Angiology 1975, 26: 365
Shinagawa T, et al: Intrahepatic portal-hepatic shunt diagnosed by ultrasonography and computed tomography: report of two cases. Acta Hepatol Jap 1986, 27: 242 (Jpn)
Sherlock S, et al: Portal-systemic encephalopathy; neurological complications of liver disease. Lancet 1954, 4: 453
Colapinto RF, et al: Formation of intrahepatic portosystemic shunts using a balloon dilatation catheter: preliminary clinical experience. AJR 1983, 140: 709
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Horiguchi, Y., Kitano, T., Imai, H. et al. Intrahepatic portal-systemic shunt: Its etiology and diagnosis. Gastroenterol Jpn 22, 496–502 (1987). https://doi.org/10.1007/BF02773819
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02773819