scholarly journals Congenital Intrahepatic Portosystemic Venous Shunt With an Associated Aneurysm: Sonographic Diagnosis

2017 ◽  
Vol 33 (4) ◽  
pp. 304-309
Author(s):  
Hamad Ghazle ◽  
Samantha Bollinger
Keyword(s):  
Hepatic Encephalopathy ◽  
Portal Vein ◽  
Incidental Finding ◽  
Vascular Connection ◽  
Sonographic Diagnosis ◽  
Left Hepatic Vein ◽  
Venous Shunt ◽  
Left Portal Vein ◽  
Portal Veins ◽  
High Degree

Intrahepatic portosystemic venous shunts with associated aneurysms are extremely rare anomalous communications between intrahepatic portal veins and systemic veins through intrahepatic venous channels. Intrahepatic portosystemic venous shunts are usually asymptomatic but can be the cause of hepatic encephalopathy and hypoglycemia, especially when a high degree of shunting exists. The sonographic incidental finding of an aneurysmal vascular connection between the left portal vein and left hepatic vein as diagnosed by sonography is presented and discussed. When evaluating patients with suspected symptoms of hepatobiliary disease, sonographers and radiologists should carefully scan and meticulously assess the liver for signs of abnormal venous communications.

scholarly journals Asymptomatic Aneurysmal Portosystemic Venous Shunt: A Case Report and Review of the Literature

2006 ◽  
Vol 49 (4) ◽  
pp. 241-244 ◽  
Author(s):  
Levent Filik ◽  
Sedat Boyacioglu
Keyword(s):  
Case Report ◽  
Hepatic Encephalopathy ◽  
Portal Vein ◽  
Ct Angiography ◽  
Middle Hepatic Vein ◽  
Review Of The Literature ◽  
Colour Doppler ◽  
Venous Shunt ◽  
Left Portal Vein ◽  
Healthy Liver

Spontaneous intrahepatic portosystemic venous shunt (SIPSVS) is relatively rare and not well recognized. Herein, we report 75-year-old female of an aneurysmal portosystemic venous shunt detected by colour Doppler ultrasound in check-up examination. A direct vascular communication between left portal vein and middle hepatic vein was confirmed by CT-angiography. The cause of intrahepatic portosystemic venous shunt is disputed. This abnormality, mainly described in cirrhotic liver and rarely in healthy liver, is usually revealed by hepatic encephalopathy or glycoregulation disorders. However, with improvements in imaging the number of reports of SIPSVS identified incidentally in patients without definite symptoms increasing.

Placement of transjugular intrahepatic portosystemic shunt via the left hepatic vein under sonographic guidance in a patient with right hemihepatectomy

2003 ◽  
Vol 44 (4) ◽  
pp. 363-365 ◽  
Author(s):  
N. Hidajat ◽  
M. Kreuschner ◽  
R. Röttgen ◽  
R.-J. Schröder ◽  
S. Schmidt ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hepatic Vein ◽  
Clinical Success ◽  
Portosystemic Shunt ◽  
Refractory Ascites ◽  
Left Hepatic Vein ◽  
Sonographic Guidance ◽  
Right Hemihepatectomy ◽  
Intrahepatic Portosystemic Shunt ◽  
Left Portal Vein

In a patient with refractory ascites after right hemihepatectomy TIPS was created between the left hepatic vein and the left portal vein via a transjugular approach. The puncture was guided only by sonography from the epigastrium. Portosystemic pressure gradient was reduced from 28 to 7 mm Hg and ascites disappeared. This case shows that TIPS can be created with technical and clinical success after right hemihepatectomy as left hepatic vein to left portal vein shunt under sonographic guidance.

Embolization of the left portal vein to inferior vena cava shunts for chronic recurrent hepatic encephalopathy via the mesenteric vein

2001 ◽  
Vol 16 (12) ◽  
pp. 1425-1428 ◽  
Author(s):  
Yuichi Takayama ◽  
Shigeaki Moriura ◽  
Junichi Nagata ◽  
Atsushi Akutagawa ◽  
Atsushi Hirano ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Inferior Vena Cava ◽  
Portal Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Mesenteric Vein ◽  
Left Portal Vein

scholarly journals Ultrasonographic characteristics and outcome of Type III umbilical-portal-systemic venous shunt

2021 ◽  
Author(s):  
Linlin Zhu ◽  
Haifang Wu ◽  
Xiang Cong ◽  
Zhe Ma ◽  
Guowei Tao
Keyword(s):  
Portal Vein ◽  
Type I ◽  
Partial Closure ◽  
Vein System ◽  
Type Iii ◽  
Type Iiia ◽  
Type Iiib ◽  
Venous Shunt ◽  
Portal Systemic Shunt ◽  
Left Portal Vein

Aims: According to a novel in-utero classification termed “umbilical-portal-systemic venous shunt (UPSVS)” recently proposed for an abnormal umbilical, portal and ductal venous system, the portal-systemic shunt belongs to type III UPSVS. This study was designed to examine the ultrasonographic characteristics and outcome of type III UPSVS.Material and methods: All cases of Type III UPSVS diagnosed at our department from April 2016 to December 2020 were retrospectively studied.Results: Seventeen patients with type III UPSVS including 12 type IIIa and 5 IIIb cases were identified. Sonography showed a shunt between the inferior left portal vein and the left hepatic vein in all type IIIa cases. Three cases of type IIIb had a combination of another shunt (2 with type I and one with type IIIa). Integrate intrahepatic portal vein system was not seen in those 2 cases of type IIIb combined with type I UPSVS, leading to termination of pregnancy (TOP). TOP occurred in 4 patients with type IIIa as requested by the parents. Two cases (type IIIa and type IIIb each) underwent surgical procedure for the closure of the shunt. Spontaneous complete closure in 4 type IIIa cases and partial closure in one type IIIb case occurred during a period of 3-16 months.Conclusions: The majority of patients had type IIIa UPSVS presenting a good outcome. The lack of integrate intrahepatic portal vein system was the main reason for TOP in patients with type IIIb UPSVS. These data suggest the UPSVS classification is a useful tool for a prognosis prediction of type III UPSVS.

scholarly journals Focal Hepatic Hot Spot Sign

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Mohamed DA ◽  
◽  
Retal H ◽  
Onka B ◽  
Latib R ◽  
...  
Keyword(s):  
Portal Vein ◽  
Superior Vena Cava ◽  
Hot Spot ◽  
Superior Vena ◽  
Vena Cava ◽  
Spot Sign ◽  
Venous Shunt ◽  
Left Portal Vein

The focal hepatic hot spot sign appears as an area of increased radiopharmaceutical uptake of the quadrate lobe of the liver in the arteial an veinous phase. This sign seen on CT is due to obstruction of the superior vena cava and portosystemic venous shunt between the superior vena cava and the left portal vein via the thoracic and internal para-umbilical veins.

scholarly journals Value of preoperative computed tomography for meso-Rex bypass in children with extrahepatic portal vein obstruction

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Huiying Wu ◽  
Ning Zhou ◽  
Lianwei Lu ◽  
Xiwen Chen ◽  
Tao Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Portal Vein ◽  
Predictive Value ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction ◽  
Left Portal Vein ◽  
History Of ◽  
Associated Malformations ◽  
Sensitivity Specificity

Abstract Background Extrahepatic portal vein obstruction (EHPVO) is the most important cause of hematemesis in children. Intrahepatic left portal vein and superior mesenteric vein anastomosis, also known as meso-Rex bypass (MRB), is becoming the gold standard treatment for EHPVO. We analyzed the value of preoperative computed tomography (CT) in determining whether MRB is feasible in children with EHPVO. Results We retrieved data on 76 children with EHPVO (50 male, 26 female; median age, 5.9 years) who underwent MRB (n = 68) or the Warren procedure (n = 8) from 2013 to 2019 and retrospectively analyzed their clinical and CT characteristics. The Rex recess was categorized into four subtypes (types 1–4) depending on its diameter in CT images. Of all 76 children, 7.9% had a history of umbilical catheterization and 1.3% had leukemia. Sixteen patients (20 lesions) had associated malformations. A total of 72.4% of Rex recesses could be measured by CT, and their mean diameter was 3.5 ± 1.8 mm (range 0.6–10.5 mm). A type 1, 2, 3, and 4 Rex recess was present in 9.2%, 53.9%, 11.8%, and 25.0% of patients, respectively. MRB could be performed in patients with types 1, 2, and 3, but those with type 4 required further evaluation. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CT were 100%, 83.8%, 42.1%, 100%, and 85.5%, respectively. Conclusions Among the four types of Rex recesses on CT angiography, types 1–3 allow for the performance of MRB.

Vasomotion and Contraction in the Perfused Mesenteric–Portal Vein: Effect of Drugs and Altered Perfusion Pressure

1971 ◽  
Vol 49 (6) ◽  
pp. 615-618 ◽  
Author(s):  
H. James Rhodes ◽  
M. C. Sutter
Keyword(s):  
Portal Vein ◽  
Perfusion Pressure ◽  
Splanchnic Circulation ◽  
Intraluminal Pressure ◽  
Longitudinal Tension ◽  
Portal Veins ◽  
Spontaneous Contractions

Isolated rabbit anterior mesenteric–portal veins (A.M.V.) which possess vasomotion were perfused with Kreb's solution in an apparatus designed so that intraluminal pressure and longitudinal tension could be measured simultaneously. The rate of vasomotion increased as perfusion pressure was increased from 0 to approximately 5 or 6 mm Hg. The amplitude of these spontaneous contractions increased to a maximum at a perfusion pressure of approximately 6 mm Hg and then decreased as perfusion pressure was raised further. Noradrenaline (10−7 g/ml) increased the longitudinal tension, but slightly decreased intraluminal pressure. Isopropylnoradrenaline (10−7 g/ml) had little effect on intraluminal pressure but decreased the amplitude of spontaneous contractions. It is suggested that the effect of perfusion pressure on the frequency and amplitude of vasomotion in the A.M.V. is related to autoregulation and that this perfused preparation may be a useful model for study of the rheology and responses to drugs of the splanchnic circulation.

Relationship Between Pre-Tips Liver Perfusion by The Portal Vein and The Incidence of Post-Tips Chronic Hepatic Encephalopathy

2001 ◽  
Vol 96 (4) ◽  
pp. 1205-1209 ◽  
Author(s):  
Ziad Hassoun ◽  
Marc Deschênes ◽  
Michel Lafortune ◽  
Michel-Pierre Dufresne ◽  
Pierre Perreault ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Portal Vein ◽  
Liver Perfusion ◽  
Chronic Hepatic Encephalopathy
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