Congenital portosystemic shunt

Case contributed by Dr Christophe Schepers

Presentation

Abdominal pain and nausea. Elevated liver function tests.

Patient Data

Age: 85 years
Gender: Female
Ultrasound

Visualization of a hypo-echoic multinodular lesion in segment 5 of the liver (Couinaud classification).

Doppler imaging shows multidirectional flow in the lesion.

Case Discussion

A multinodular hypoechoic lesion, intrahepatic, with multidirectional flow on Doppler imaging is strongly suggestive of a vascular malformation.

Dynamic ultrasound study shows a portal branch and hepatic vein branch running into this lesion, making this a portosystemic shunt. With an insignificant clinical history (in particular no TIPSS procedure) and no prior ultrasound studies, this portosystemic shunt is presumed to be congenital.

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Case information

rID: 56099
Published: 12th Oct 2017
Last edited: 14th Aug 2019
Inclusion in quiz mode: Excluded

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