PMC9905039_01
(A) Chest X-ray showing mild cardiomegaly (star) and prominent vascular marking (arrow). (B) Ultrasonography image showing side-to-side communication (curved arrow) between the main portal vein (star) and inferior vena cava (solid arrow) and also the patent superior mesenteric vein (arrowhead). (C) Corresponding CT scan image at a similar level showing side-to-side communication (curved solid arrow) between the main portal vein (star) and inferior vena cava (solid arrow), shunt size (line), and also the patent hypoplastic intrahepatic portal venous branches (simple arrow).
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FIG1
Chest X-ray showed mild cardiomegaly with increased pulmonary vascular markings (Figure 1A). Doppler ultrasound showed dilated extrahepatic main PV with hypoplastic intrahepatic portal venous branches arising from the dilated segment and a large communicating shunt between IVC and the main PV (Figure 1B). Computed tomography (CT) angiography confirmed the Doppler findings and a diagnosis of type II Abernethy malformation was made (Figure 1C).
(A) Digital subtraction angiogram showing side-to-side communication (curved bold arrow) between the main portal vein (star) and inferior vena cava (solid arrow) along with patent hypoplastic intrahepatic portal venous branches (simple arrow). (B) Digital subtraction angiogram showing post-deployment of the vascular plug (arrowhead) showing stasis and hepatic parenchymal blush (double arrow).
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FIG2
Multiple catheter angiograms were taken to establish the patency of the intrahepatic portal venous branches (Figure 2A). The device was deployed across the shunt via the femoral route and angiograms were taken from the jugular route, which showed a visualization of the intrahepatic portal branches and immediate closure of the shunt (Figure 2B).