PMC5484609_01
B mode ultrasound image (A) shows the hypoechoic tract (arrow) which is extending from RPV to the IVC. Color Doppler ultrasound images (B, C) reveal blood flowing from RPV to IVC via this porto-caval shunt (arrows). B mode ultrasound image obtained on the 33rd day after birth (D) shows that the shunt closed and became a fibrotic ligamentous structure (arrow). Illustration (E) shows the normal pathway of umbilical vein catheterization (red arrows) and the abnormally located shunt (white open arrow). IVC - vena cava inferior; RHV - right hepatic vein; MHV - middle hepatic vein; LHV - left hepatic vein; PV - portal vein; RPV - right portal vein; LPV - left portal vein; UV - umbilical vein; DV - ductus venosus; * portal sinus.
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Abdominal ultrasound findings were as follows: dilatations of the right-left portal vein, a thin hypoechoic tract between the right portal vein and inferior vena cava (IVC) (Figure 1A). Color Doppler US confirmed blood flow in these vessels (Figure 1B, 1C). Blood flow through the shunt gradually decreased on follow-up Doppler ultrasound examinations which closed on the 33rd day since birth and became a thin, hyperechoic ligamentous structure equivalent to the 'ligamentum venosum' (Figure 1D).