Colour Doppler imaging of shunts from the left portal branch in portal hypertension. Description of a typical pattern.

Purpose: To describe the typical colour Doppler appearance of a shunt through the parenchyma of the left lobe of the liver in portal hypertension.

Material And Methods: Ultrasound images of 141 patients with biopsy-verified cirrhosis were reviewed. Special note was taken of the appearance of shunts from the left portal branch.

Results: In 28 patients, shunts from the left portal branch were detected ultrasonographically, 10 of which ran through the liver parenchyma on a course separated from the ligamentum teres. Seven of these 10 followed a tortuous course just below the surface of the liver creating a ball or corkscrew-like pattern.

Conclusion: Shunts from the left portal branch are not uncommon and may represent the only ultrasonographically detectable pathology in these patients. Recognition of the typical pattern will facilitate their detection.