Intrahepatic Portosystemic Venous Shunt Research Articles

Intrahepatic portosystemic venous shunt in liver cirrhosis: is it congenital or acquired?

Intrahepatic portosystemic venous shunt in liver cirrhosis: is it congenital or acquired?M KudoAudio Available | Share

Ultrasound diagnosis of congenital intrahepatic portosystemic venous shunt

There are few radiologic descriptions of intrahepatic portosystemic venous shunts and all in adults. A case is reported of a newborn where the diagnosis of shunt was made with color Doppler and where the shunt resolved spontaneously at one year of age. Proposed etiologies for intrahepatic portovenous shunts are discussed.

Intrahepatic portosystemic venous shunt.

Among numerous variations of communications between the portal and systemic venous circulations, intrahepatic shunts between portal and systemic veins have seldom been described [1 , 2]. Recently we encountered an intrahepatic portosystemic venous shunt directly connecting the right portal vein to the inferior portion of the vena cava. We describe our case and discuss 14 other previously published cases [110].

Intrahepatic portosystemic venous shunt: occurrence in patients with and without liver cirrhosis

Portosystemic venous shunt within the hepatic parenchyma is rare, and its cause is disputed. Only 12 cases have been reported in the literature. Four new patients are presented here, all of whom had cerebral manifestations due to elevated blood-ammonia levels. One patient, initially misdiagnosed as having a psychiatric disorder, had multiple small portohepatic venous shunts in the peripheral hepatic parenchyma that were believed to be congenital in origin. The other three patients with clinical evidence of cirrhosis and portal hypertension had large tubular shunts between the posterior branch of the portal vein and the inferior vena cava. Shunts of this type were considered to be the collateral pathways developed in the hepatic parenchyma as a result of portal hypertension. The diagnosis of intrahepatic portosystemic venous shunts was established by angiography in all four patients. Sonography and CT failed to show the multiple small shunts, but did provide diagnostic information concerning the large tubular shunts. Intrahepatic portosystemic venous shunt can be the cause of hepatic encephalopathy. One should be familiar with the typical radiographic manifestations of this condition to prevent misdiagnosis as a psychiatric or neurologic disorder.

Nonsurgical production of intrahepatic portosystemic venous shunts in portal hypertension with the double lumen balloon catheter

A nonsurgical production of intrahepatic shungs between the left portal and left hepatic vein was evaluated in twelve dogs with acute portal hypertension. Dilatation of the intrahepatic tract was achieved by means of a double lumen balloon catheter introduced into the portal system with the transjugular approach. The shunts proved to be effective in immediate reduction of increased portal pressure and no significant complications were encountered.