Presentation
Presented with vague abdominal pain, but was pain free by the time of the follow up CT study.
Patient Data
A tortuous and dilated vessel at the superior aspect of the right hepatic lobe appears to communicate with both the right portal vein and hepatic vein.
tortuous right portal vein with an aneurysmal communication to the right hepatic vein in segment 7 of the liver, consistent with an intra-hepatic portosystemic venous shunt
prominent main portal vein
no evidence of portal vein thrombosis
no evidence of cirrhosis or portal vein cavernous transformation
cholelithiasis
prostatomegaly, sigmoid diverticulosis
Case Discussion
The patient in this case had no evidence of cirrhosis, or history of biopsy/surgery in the right lobe of the liver, indicating that the intrahepatic portosystemic venous shunt is most likely congenital.
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