Hepatobiliary and pancreatic: Commentary

Abstract

Journal of Gastroenterology and HepatologyVolume 18, Issue 9 p. 1104-1104 Free Access Hepatobiliary and pancreatic: Commentary First published: 11 August 2003 https://doi.org/10.1046/j.1440-1746.2003.t01-1-03163.xAboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat INTERPRETATION OF FIGURE 1 (SEE PAGE 1101) This calcific vessel lies between the right and left hepatic lobes. Although it has a lumen 7 mm in diameter, it is obliterated. This sturucture runs between the right and left lobes from the left to the right anteriorly. There is no tissue in this area except for the ductus venosus (duct of Arantius). DIAGNOSIS: CALCIFIED DUCTUS VENOSUS The ductus venosus functions in the fetal life connecting the umbilical vein to the inferior vena cava, so that a large proportion of the umbilical vein blood bypasses the liver and rapidly reaches the central circulation. It closes rapidly after birth, and turns into a fibrous band or ligament (Ligamentum venosus). More than 20 cases of patent ductus venosus occurring in adults have been reported.1,2 Clinical manifestations include portosystemic encephalopathy, pulmonary hypertension and fatty degeneration of the liver. Familial patent ductus venosus has also been documented.3 Clearly, in the present patient the ductus venosus did not close and turn into a ligament at birth; it may have functioned as a blood conduit for some time postnatally. Although she had no history of umbilical sepsis, it is a possibility because of calcification and the presence of ductal lumen. Figure 2 shows a scan 2 cm cranial to Fig. 1, showing the entire span of the structure. Figure 2Open in figure viewerPowerPoint Scan 2 cm cranial to that illustrated in Figure 1, showing the entire span of the structure. REFERENCES 1 Ohnishi K, Hatano H, Nakayama T et al. An unusual portal-systemic shunt, most likely through a patent ductus venosus. Gastroenterology 1983; 85: 962 – 5. 2 Shen B, Younossi ZM, Dolmatch B et al. Patent ductus venosus in an adult presenting as pulmonary hypertension, right-sided heart failure and portosytemic encephalopathy. Am. J. Med. 2001; 110: 652 – 61. 3 Jacob S, Farr G, DeVun D et al. Hepatic manifestations of familial patent ductus venosus in adults. Gut 1999; 45: 329 – 30. Volume18, Issue9September 2003Pages 1104-1104 FiguresReferencesRelatedInformation