Congenital absence of the portal vein in a patient with multiple vascular anomalies


Ogul H., BAYRAKTUTAN Ü., YALÇIN A., Turan M. I. , Ozgokce M., EREN S., ...More

SURGICAL AND RADIOLOGIC ANATOMY, vol.35, no.6, pp.529-534, 2013 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 35 Issue: 6
  • Publication Date: 2013
  • Doi Number: 10.1007/s00276-012-1059-z
  • Journal Name: SURGICAL AND RADIOLOGIC ANATOMY
  • Journal Indexes: Science Citation Index Expanded, Scopus
  • Page Numbers: pp.529-534
  • Keywords: Abernethy malformation, Computed tomography, Congenital vascular anomalies, Anatomical variation

Abstract

A 15-year-old male patient accepted to emergency department with nausea, vomiting, sleepiness, and severe epigastric pain. The patient has a history of mild mental retardation since his childhood. Physical examination showed epigastric tenderness. Laboratory findings were consistent with mildly increased liver enzymes and hyperammonemia. Result of abdominal ultrasound was suboptimal due to lack of patient cooperation. Patient underwent abdominal and thoracic computed tomography (CT) examination to investigate the possible causes of hyperammonemia and liver disease. The CT scan showed the absence of portal vein with direct connection of portomesenteric system with systemic venous circulation. There were also various arterial and venous anomalies along with multiple hepatic masses. Whole anatomy of the thorax and abdomen was delineated with multiplanar reformatted images and maximum intensity projection technique. Imaging findings are consistent with Type Ib Abernethy malformation. The patient also underwent brain magnetic resonance imaging to investigate the presence of central nervous system changes due to hyperammonemia.