Abstract
A case of an aneurysmal portosystemic venous shunt detected by colour Doppler ultrasound (CDUS) is presented. A young female patient complained of postprandial fatigue and had paroxysmal tachycardia. A direct vascular communication between right portal vein and right hepatic vein was found at CDUS and confirmed by direct portal angiogram. Using detachable coils a complete occlusion of the intrahepatic shunt was obtained. Reports from the literature regarding portovenous aneurysms are reviewed.
Eine junge Patientin berichtet über verstärkte postprandiale Müdigkeit und kurzzeitiges Herzrasen. Während der sonographischen Untersuchung wurde eine direkte Verbindung des rechten Pfortaderastes mit der rechten Lebervene entdeckt. Die portale Angiographie bestätigte den Befund. Mittels Spiralen wurde die vaskuläre Kurzschlußverbindung verschlossen. Literaturberichte bezüglich portovenöser systemischer Shuntverbindungen werden diskutiert.
Key words:
Colour Doppler sonography - Vascular malformation - Liver
Schlüsselwörter:
Farbkodierte Doppler-Sonographie - Gefäßmalformation - Leber
References
-
01
Tomczak R, Helmberger T, Gorich J, Merkle E, Brambs HJ, Rieber A.
Abdominal arteriovenous and arterioportal fistulas: etiology, diagnosis, therapeutic possibilities.
Z Gastroenterol.
1997;
35
555-562
-
02
Park JH, Cha SH, Han JK.
Intrahepatic portosystemic venous shunt.
Amer J Roentgenol.
1990;
155
527
-
03
Mori H, Hayashi K, Fukuda T, Matsunaga N, Futagawa S, Nagasaki M, Mutsukura M.
Intrahepatic portosystemic venous shunt: occurrence in patients with and without liver cirrhosis.
Amer J Roentgenol.
1987;
149
711-714
-
04
Grattagliano A, Rapaccini GL, Camaldo Gpompili M, Mastromatteo AM, Cotroneo AR, Gasbarrini G.
Spontaneous intrahepatic venous shunt in a patient with cirrhosis: diagnosis by combined color Doppler and pulsed Doppler ultrasonography.
Liver.
1997;
17
307-310
-
05
Paley MR, Farrant P, Kane P, Heaton ND, Howard ER, Karani JB.
Developmental intrahepatic shunts of childhood: radiological features and management.
Europ Radiol.
1997;
7
1377-1382
-
06
Raskin NH, Price JB, Fishman RA.
Portal systemic encephalopathy due to congenital intrahepatic shunts.
New Engl J Med.
1964;
270
225-229
-
07
Sekido H, Nakano A, Takahashi T, Matsuo K, Mochizuki Y, Fukushima T, Tsuchiya S, Shimada H.
Hepatic encephalopathy secondary to a large - caliber porto-hepatic venous shunt. A case report.
Hepatogastroenterology.
1992;
39
316-318
-
08
Hondo T, Teragawa H, Munemori M, Morishima N, Watanabe H, Ogata S, Ohe H, Yoshikawa M, Ohbayashi M.
Portal-hepatic venous shunt through a portal aneurysm complicated by hepatic encephalopathy and pulmonary hypertension.
Intern Med.
1997;
37
790-793
-
09
Sakai T, Katoh T, Asada K, Yagi K, Yoshida R.
Portal hepatic venous shunt via an intrahepatic portal vein aneurysm.
Intern Med.
1992;
31
899-903
-
10
Tanaka S, Kitamura T, Fujita M, Iishi H, Kasuagai H, Nakanishi K, Okuda S.
Intrahepatic venous and portal venous aneurysms examined by color Doppler flow imaging.
J Clin Ultrasound.
1992;
20
89-98
-
11
Gheorghiu D, Leibowits O, Bloom RA.
Case report: asymptomatic aneurysmal intrahepatic porto-hepatic venous shunt-diagnosis by ultrasound.
Clin Radiol.
1994;
49
64-65
-
12
Takayasu K, Morijama N, Shima Y.
Spontaneous portal hepatic venous shunt via an intrahepatic portal vein aneurysm.
Gastroenterology.
1984;
86
945-948
-
13
Chagnon S, Vallee C, Barge J, Chevalier J, Le Gal J, Blery M.
Aneurysmal portohepatic venous fistula: report of two cases.
Radiology.
1986;
159
693-695
-
14
Hyung P, Hoon C, Han JK, Han MC.
Intrahepatic portosystemic venous shunt.
Amer J Roentgenol.
1990;
155
527-528
Dr. G. Bodner
Universitätsklinik Innsbruck
Anichstraße 35
A-6020 Innsbruck
