Congenital Absence of the Portal Vein

A 59-year-old woman presented with abdominal bloating, elevated alkaline phosphatase and transaminases, and computed tomography abdomen/pelvis demonstrating large right-sided hepatic masses. A percutaneous fine needle aspiration demonstrated hepatocellular neoplasm concerning for hepatocellular carc...

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Bibliographic Details
Published in:The American surgeon 2023-04, Vol.89 (4), p.1031-1033
Main Authors: Beal, Eliza W., Foley, Kirstin, Washburn, Ken, Tsung, Allan
Format: Article
Language:English
Subjects:
Abdomen
Abdomen - pathology
Abnormalities
Alkaline phosphatase
Bile ducts
Carcinoma, Hepatocellular - complications
Carcinoma, Hepatocellular - diagnostic imaging
Carcinoma, Hepatocellular - surgery
Catheters
Computed tomography
Female
Fistula
Gallbladder
Hemodynamics
Hepatocellular carcinoma
Humans
Hyperplasia
Liver
Liver cancer
Liver Neoplasms - complications
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - surgery
Magnetic resonance imaging
Medical screening
Middle Aged
Neoplasms
Patients
Pelvis
Portal vein
Portal Vein - abnormalities
Shunts
Thoracic surgery
Tomography
Ultrasonic imaging
Veins & arteries
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Summary:A 59-year-old woman presented with abdominal bloating, elevated alkaline phosphatase and transaminases, and computed tomography abdomen/pelvis demonstrating large right-sided hepatic masses. A percutaneous fine needle aspiration demonstrated hepatocellular neoplasm concerning for hepatocellular carcinoma. Preoperative imaging demonstrated possible porto-caval shunt. She underwent uneventful right hepatic lobectomy with confirmation of porto-systemic shunt. Congenital porto-systemic shunt, or Abernethy malformation, is rare and is associated with congenital cardiac and gastrointestinal abnormalities. Additionally, congenital porto-systemic shunt is associated with increased risk of hepatic neoplasms including hepatocellular carcinoma. Recommended surveillance for these patients is not well defined.
ISSN:0003-1348
1555-9823
DOI:10.1177/0003134820960064