The absence of the horizontal portion of the left portal vein is rare, and it is often not diagnosed by ultrasound. This article reports a case where ultrasound identified a structural anomaly between the gallbladder and the round ligament of the liver, and then computed tomography confirmed the absence of the horizontal portion of the left portal vein. We proposed the possible etiologies from an embryonic development perspective, and described the questions to be further investigated after a literature review.
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