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Purpose: We present the case of a rare extrahepatic portocaval shunt that resulted in communication of the portal vein and the inferior vena cava (IVC) at the level between two right renal veins that was incidentally diagnosed with contrast-enhanced computed tomography (CECT) in an asymptomatic patient.

Methods: A woman in her sixties with abdominal pain and diarrhea of unclear origin underwent exploratory abdominal CECT.

Results: The CECT incidentally revealed an extrahepatic portocaval shunt, whereby a vessel arising from the portal vein superior to the confluence of the superior mesenteric and splenic veins drained into the posterior aspect of the IVC between two right renal veins.

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Introduction: Electrophysiologic (EP) procedures are typically performed via the femoral venous system, but in some patients, the inferior vena cava (IVC) is unavailable. The hepatic vein has emerged as a viable alternative to femoral access, providing an inferior route that accommodates large sheaths required for better catheter manipulation. Although the percutaneous transhepatic approach has been used successfully in the pediatric population, its use in adults is scarce, with a complication rate of approximately 5%.

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We report a rare case of adenosquamous carcinoma of the gall bladder (GB) causing portal vein tumor thrombus. A 40-year-old gentleman presented with acute-onset right upper abdominal pain. Ultrasonography revealed multiple calculi in the GB with wall thickening, suggesting acute cholecystitis.

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Ectopic varices can result from portal vein stenosis following pancreaticoduodenectomy with concomitant portal vein resection reconstruction, and they can cause gastrointestinal bleeding. Although they can sometimes be fatal, various treatments have been reported. This report describes a case in which a percutaneous transhepatic approach was used to simultaneously perform variceal embolization and portal vein stenting in which a favorable outcome was achieved.

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Impact of aging on hepatic reserve after preoperative portal vein embolization in hepatectomy for perihilar cholangiocarcinoma.

Asian J Surg

December 2024

Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.

Purpose: In the current situation of an increasing older adult population with perihilar cholangiocarcinoma (PHCC), the benefits and risks of surgical treatment of PHCC in older people remain controversial. Portal vein embolization (PVE) is a useful preoperative procedure to improve hepatic reserve in the future remnant liver (FRL) and avoid postoperative liver failure after extended hepatectomy for PHCC. This study aimed to evaluate the influence of aging on PVE.

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