PMC6159285_01
(a) Axial CT image (1 mm, maximum intensity projection) showing an engorged left renal vein posteriorly, relative to the portal vein, due to the congenital extrahepatic portosystemic shunt in a 68-year-old asymptomatic female patient. (b) Coronal reconstructed CT image (5 mm, maximum intensity projection) showing a tortuous and dilated left gastric (shunt) and splenic vein within the left upper abdomen and communicating superior mesenteric vein and portal vein with the left renal vein and inferior vena cava (Supplementary Video 1a,b).
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fig1
The appearance of the liver was consistent with fatty infiltration but was otherwise unremarkable (Figure 1a,b).
PMC6159285_02
(a) Axial CT image of the upper abdomen (1 mm maximum intensity projection) showing a distended left gastric vein acting as a shunt (asterisk) anterior to the portal vein (arrow), which is seen anterior to the normal size inferior vena cava. (b) Coronal reconstructed CT image (1 mm, maximum intensity projection) showing the shunt joining at the confluence of the superior mesenteric and splenic veins (side-to-side anastomosis) within the upper abdomen, surrounding the head of the pancreas (Supplementary Video 2a,b).
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fig2
The findings suggested an incidental Type II CEPS, draining into the left renal vein (Figure 2a,b).