Spontaneous intrahepatic portosystemic venous shunt in a patient with cirrhosis: diagnosis by combined color Doppler and pulsed Doppler ultrasonography

Abstract

Large spontaneous intrahepatic portosystemic venous shunts are occasionally found and their diagnosis by Doppler sonography is rarely reported. The authors describe a case of spontaneous intrahepatic porto‐systemic venous shunt in liver cirrhosis diagnosed by color Doppler and characterized by an unusual pulsed Doppler spectrum: a continuous flat portal‐like pattern of flow in the portal branch, and in both the shunt and the hepatic vein,

Combination therapy using PSE and TIO ameliorates hepatic encephalopathy due to intrahepatic portosystemic venous shunt in idiopathic portal hypertension

“…Two theories, i.e. the congenital theory and the acquired theory, have been postulated ( 1 , 11 , 12 ). The former suggests a persistent embryonic venous anastomosis while the latter suggests that the shunt results from portal hypertension, trauma, or rupture of a portal vein aneurysm.…”

“…in 1964 ( 1 ). Intrahepatic PSS is now encountered more frequently with the developments of diagnostic imaging ( 2 , 3 ). Clinical manifestations of intrahepatic PSS depend on the shunt flow, and a shunt with a high flow may cause hepatic encephalopathy.…”

Hepatic encephalopathy due to intrahepatic portosystemic venous shunt successfully treated by balloon occluded retrograde transvenous embolization with GDCs

“…Two theories, the congenital origin theory and the acquired theory, have been reported (1, 3). The former suggests a persistent embryonic venous anastomosis, such as the ductus venosus or a vitelline vein (1) while the latter suggests that the shunt results from portal hypertension, trauma, or rupture of a portal vein aneurysm (4). …”

“…Although reports have been rare since the first report by Raskin et al in 1964 (1), intrahepatic portosystemic venous shunt (IPSVS) has become encountered more frequently in parallel with the development of various imaging modalities such as ultrasonography and computed tomography (CT) (2–4). However, even now, IPSVS is not widely known and is sometimes overlooked.…”

Asymptomatic Congenital Intrahepatic Portosystemic Shunt

“…Color Doppler imaging reveals a direct communication of color flow signals between the portal and hepatic veins, with changes within the spectral waveform from a continuous waveform signal, as seen in the portal vein, to a turbulent signal within the shunt region to a biphasic waveform as seen within the hepatic vein[7]. MRI demonstrates flow void within the region of the shunt.…”