Purpose: To observe a case of congenital extrahepatic portosystemic shunt and discuss it from the embryological and clinical viewpoints.
Methods: An 85-year-old female cadaver was employed for a dissection course at Aichi Medical University in 2009.
Results: There was no evidence of liver cirrhosis macroscopically or microscopically. A portosystemic shunt was observed that involved communication between the inferior mesenteric vein, inferior vena cava (IVC), and left ovarian vein by a single Y-shaped shunt vessel.
Conclusions: To the best of our knowledge, this is the first reported case of the above-mentioned three veins being connected by a single Y-shaped shunt vessel. Considering the other venous diameters, the shunt appeared to flow into the splenic vein and IVC. It cannot be denied that this shunt may have led to hepatic encephalopathy, although the shunt effect may have been minimal. Embryological development of IVC appears to occur close to the plexus of anastomosing vitelline veins, forming the portal vein.
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http://dx.doi.org/10.1007/s00276-013-1230-1 | DOI Listing |
Cureus
November 2024
Division of Interventional Radiology, Columbia University Irving Medical Center, New York, USA.
Aim This study aims to evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) check and revision procedures performed in a freestanding interventional radiology (IR) outpatient facility. Methodology A total of 40 patients (male 31:female 9, median age 60 years old) underwent a TIPS check and/or revision at a freestanding IR outpatient facility between 2009 and 2017. Procedures were performed using a mobile C-arm unit under intravenous (IV) moderate sedation, with the patient discharged home on the same day.
View Article and Find Full Text PDFThromb Haemost
December 2024
Dep of Cardiological, Thoracic and Vascular Sciences, University of Padua ; 2nd Chair of Internal Medicine, Padua, Italy.
Background: Portal vein system-specific risk factors contributing to portal vein thrombosis in cirrhosis are poorly investigated.
Aims: To quantify contact system and intrinsic pathway activation in peripheral compared to portal venous blood in patients with decompensated cirrhosis.
Methods: Adult patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt underwent simultaneous blood sampling from a peripheral vein and the portal vein.
Am J Gastroenterol
November 2024
Division of Gastroenterology and Hepatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Introduction: Heart failure (HF) after transjugular intrahepatic portosystemic shunt (TIPS) placement affects up to 20% of patients. Understanding factors associated with post-TIPS HF is critical. Cirrhotic cardiomyopathy (CCM) is associated with adverse clinical outcomes.
View Article and Find Full Text PDFClin J Gastroenterol
December 2024
Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
We report the case of a 70-year-old woman with advanced hepatic encephalopathy (HE) secondary to metabolic dysfunction-associated steatohepatitis (MASH)-related cirrhosis who exhibited an excellent response to portosystemic shunt embolization. Four years earlier, she was diagnosed as having MASH-related cirrhosis accompanied by multiple mesenteric vein-inferior vena cava shunts. As her condition progressed, she suffered recurrent HE that was unresponsive to oral medication, prompting the decision to proceed with shunt embolization.
View Article and Find Full Text PDFCVIR Endovasc
December 2024
Department of Gastroenterology, Medical University Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Background: Three patients with portal hypertension and gastrointestinal bleeding due to non-cirrhotic portal vein thrombosis were treated with portal venous recanalization transjugular intrahepatic portosystemic shunt (PVR-TIPS) via a trans-splenic access.
Main Body: A "bottoms-up" retrograde puncture of the right hepatic vein was performed using a re-entry catheter to gain access to the right hepatic vein. In all patients a successful retrograde puncture of the right hepatic vein was achieved, thereby restoring the splenoportal tract.
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