Congenital Portosystemic Shunts

Han, Byoung Hee; Park, Sung Bin; Song, Mi Jin; Lee, Kyung Sang; Lee, Young-Ho; Ko, Sun Young; Lee, Yeon Kyung

doi:10.7863/jum.2013.32.1.45

Cited by 31 publications

(34 citation statements)

References 19 publications

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“…Several fetal US findings can raise the suspicion of CPSS [ [12] , [13] , [14] ]. Nevertheless, agenesis of ductus venosus (ADV) [ 7 , 9 , 11 , 13 ] and intrauterine growth restriction (IUGR) [ 6 , 8 , 9 , 14 , 15 ] are among the most frequently reported findings with CPSS. Two of our patients who were diagnosed prenatally had ADV on their fetal US (Case 1 & 2).…”

Section: Discussionmentioning

confidence: 99%

“…This is quite characteristic for CPSS and may be found incidentally during newborn screening [ [18] , [19] , [20] ]. Transient neonatal cholestasis may also complicate both intra- & extrahepatic CPSS [ 6 , 8 , 14 , 17 , 21 ], and may co-exist with other more common causes of neonatal cholestasis such as biliary atresia [ 6 , 22 ]. Interestingly, both neonatal galactosemia and cholestasis were found in our patient (Case 5).…”

Section: Discussionmentioning

confidence: 99%

“…However, with large communications involving the extrahepatic portal veins and ductus venosus and in those with shunt ratio >30% that may persist throughout life and carry risks of complications, closure of the shunt is mandated [ 1 , 2 , 15 , 22 ]. Both surgical and endovascular embolization have been described as therapeutic options for shunt closure [ 6 , 13 , 14 , 20 , 27 , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] ].…”

Section: Discussionmentioning

confidence: 99%

“…It is minimally invasive, associated with less morbidity and the patient can be discharged home on the same day of the procedure. Furthermore, it can be carried out at any age in symptomatic patients, and with prenatal diagnosis early intervention is becoming more feasible [ 13 , 14 , 31 ]. The procedure was carried out on the second and seventh day of life in Case 1 and 2 respectively.…”

Section: Discussionmentioning

confidence: 99%

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Pre and postnatal diagnosis of congenital portosystemic shunt

Mreish

Hamdan

2020

International Journal of Pediatrics and Adolescent Medicine

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Introduction Congenital portosystemic shunts (CPSS) are rare vascular malformations that can lead to severe complications. With advanced imaging techniques, diagnosis is becoming more feasible occurring in fetal life. Different approaches have been adopted to manage these cases, with an increased utilization of interventional therapy recently. This cohort aims to describe the course of children diagnosed with CPSS and the impact of interventional therapy on the outcome. Methods Retrospective chart review was done for all patients who were diagnosed with CPSS in our institution between January 2006 and December 2015. Results Six patients were diagnosed with CPSS. During this period, 8,680 mothers carrying 9548 fetuses underwent fetal ultrasound examinations. Three patients were diagnosed antenatally at a median [IQ] gestational age of 33 [26–33] weeks, and three patients were diagnosed postnatally at 0, 2, and 43 months, respectively. At a median follow-up of 87 [74–110] months, 5 patients are alive; 4 of whom had received transcatheter closure for different indications, and one who had spontaneous resolution of her CPSS. One infant died at the age of 6 weeks secondary to sepsis. Conclusion CPSS can result in significant complications in children. Interventional therapy is feasible at any age group, but long-term follow-up is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pre and postnatal diagnosis of congenital portosystemic shunt

Mreish

Hamdan

2020

International Journal of Pediatrics and Adolescent Medicine

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“…Prenatal identification of shunt has become more frequent with the technical improvement of diagnostic imaging; however, this method has limitations 910 Postnatal ultrasound is important and useful in confirming changes detected in prenatal testing 9…”

Section: Discussionmentioning

confidence: 99%

Congenital intrahepatic portosystemic shunt diagnosed during intrauterine life

Bellettini

Wagner

Balzanelo

et al. 2016

Revista Paulista de Pediatria (English Edition)

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Objective:To report a patient with prenatal diagnosis of portosystemic shunt; a rare condition in humans.Case description:17-Day-old female infant admitted for investigation of suspected diagnosis of portosystemic shunt, presumed in obstetric ultrasound. The hypothesis was confirmed after abdominal angiography and liver Doppler. Other tests such as echocardiography and electroencephalogram were performed to investigate possible co-morbidities or associated complications, and were normal. We chose conservative shunt treatment, as there were no disease-related complications and this was intrahepatic shunt, which could close spontaneously by the age of 2 years.Comments:Portosystemic shunt can lead to various complications such as hepatic encephalopathy, hypergalactosemia, liver tumors, and hepatopulmonary syndrome. Most diagnoses are done after one month of age, after such complications occur. The prenatal diagnosis of this patient provided greater security for the clinical picture management, as well as regular monitoring, which allows the anticipation of possible complications and perform interventional procedures when needed.

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Imaging of fetal precordial venous system by four‐dimensional ultrasound with spatiotemporal image correlation technology

Leung¹

2021

J of Clinical Ultrasound

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Despite the use of two-and three-dimensional color Doppler ultrasonography, the prenatal sonographic evaluation of precordial venous system remains difficult. Spatiotemporal image correlation (STIC) technology has been well described for the assessment of the fetal heart, but not of precordial venous system. As demonstrated in this report, it is feasible to use four-dimensional ultrasound with STIC rendered volume in glass-body mode and tomographic ultrasound imaging to image this system including the connection and drainage of the ductus venosus, hepatic veins and inferior vena cava to the fetal heart. This novel approach can increase the understanding of this venous system.

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Congenital Portosystemic Shunts

Cited by 31 publications

References 19 publications

Pre and postnatal diagnosis of congenital portosystemic shunt

Pre and postnatal diagnosis of congenital portosystemic shunt

Congenital intrahepatic portosystemic shunt diagnosed during intrauterine life

Imaging of fetal precordial venous system by four‐dimensional ultrasound with spatiotemporal image correlation technology

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