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Congenital intrahepatic portosystemic venous shunts are rare vascular malformations which are incidentally discovered on imaging or once hepatic encephalopathy becomes clinically apparent. Surgical ligation and endovascular embolization are potential treatments.

We present a case where low attenuation gallstones are visible on CT only on delayed imaging secondary to gallbladder opacification from vicarious excretion of contrast. We discuss heterotopic accumulation of contrast in the gallbladder and its potential diagnostic utilization in the detection of occult pathology.

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