An unusual portal-systemic shunt, most likely through a patent ductus venosus
| Autor: | Takatsune Nakayama, Kunio Okuda, Kunihiko Ohnishi, Hitoshi Hatano, Kunihiko Kohno |
|---|---|
| Rok vydání: | 1983 |
| Předmět: |
medicine.medical_specialty
Cirrhosis Hepatology business.industry Gastroenterology medicine.disease Inferior vena cava Shunt (medical) Catheter Contrast medium Blood pressure medicine.vein Internal medicine Varicose veins cardiovascular system medicine Cardiology cardiovascular diseases Radiology Portosystemic shunt medicine.symptom business |
| Zdroj: | Gastroenterology. 85:962-965 |
| ISSN: | 0016-5085 |
| DOI: | 10.1016/0016-5085(83)90451-1 |
| Popis: | A 46-yr-old man with cirrhosis presented with mental confusion, headache, and nausea. Colloid liver scintigraphy showed a defect in the hilar area, and portograms after superior mesenteric arteriography demonstrated varicose veins in the same area. Computed tomography revealed a sausage-shaped lowdensity channel connecting the hepatic hilum and the inferior vena cava, and bolus injection contrast enhancement demonstrated transit of contrast medium from the portal vein directly into the inferior vena cava through this channel. Real-time ultrasound demonstrated a large conduit contiguous from the portal vein to the inferior vena cava through and behind the liver. The catheter introduced into the inferior vena cava opacified a large opening of this shunt below the right and left hepatic vein openings. Measurements of blood pressure, ammonia, and Pao 2 clearly indicated that portal vein blood was being shunted through this channel. These findings are highly suggestive of a portosystemic shunt through a patent ductus venosus. |
| Databáze: | OpenAIRE |
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