Presentation
Abdominal pain, dyspepsia and progressive distension
Patient Data
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Multifocal hepatocellular carcinomas involve hepatic subsegments VIII and IVa and display typical enhancing criteria, early arterial enhancement followed by rapid washout in portovenous phase. Early filling of the right and left portal branches are seen in arterial phase due to an arterio-portal shunt involves the right portal vein branch. Hepatic cirrhotic changes, splenomegaly, portal hypertension, small bowel congestion, calcular gall bladder and ascites are also noted.
Case Discussion
Intrahepatic arterio-portal shunt can occur as a complication of hepatocellular carcinoma (tumorous shunt) or non-tumorous in case of hepatic intervention.