Spontaneous spleno-renal and spleno-caval shunts may be anatomically and functionally important in portal hypertension syndromes, as demonstrated by the distinct opacification of the inferior vena cava observed after portal venography with iodine contrast media. Part of the course of these porto-caval anastomotic vessels can be visualized by ultrasonography opposite the left adrenal gland and in the space between the spleen and the left kidney. The images obtained are characteristic enough for the diagnosis of spleno-renal shunt to be suspected before it is confirmed by portal venography, as was the case in the four patients with hepatic cirrhosis reported by the authors.
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