Surgical treatment of an enormous aneurysmal portahepatic venous fistula: Report of a case

Abstract

We report herein the case of a 20-year-old woman in whom an enormous aneurysmal portahepatic venous fistula was found. The portal aneurysm developed in the anterior inferior segment of the right hepatic lobe, and communicated with the right portal vein and the right hepatic vein. Due to the enormous size of the shunt, and because the patient's venous blood ammonia level increased by about twofold after eating, a right lobectomy of the liver was performed. A review of the available literature and a discussion of the most appropriate treatment follows the presentation of this case.

Congenital intrahepatic portohepatic shunt managed by interventional radiologic occlusion: a case report and literature review

“…Even in asymptomatic cases, a preemptive closure of the shunt is highly recommended if the shunt ratio exceeds 60% [8]. Surgical ligation of CPSS [9,10] has been largely replaced by radiologic intervention using various materials for shunt closure [11].…”

Intrahepatic Aneurysmal Portohepatic Venous Shunt: Embolization with a Tissue Adhesive Solution

“…In symptomatic patients, the treatment of this type of lesion is necessary. The surgical options include ligation of the portal vein, resection of the lesion, or even lobectomy, 1,4 but all these surgical interventions have an inherent mortality that has never been reported in patients treated with interventional therapies.…”

“…1 These shunts are sometimes an incidental finding during an ultrasound examination or computed tomography (CT) performed for vague abdominal symptoms or during the follow-up for cirrhosis. 2 The possible therapies in cases of symptomatic shunts are surgery, 3,4 embolization, 5,6 or, rarely, dietary restrictions. 1 We describe a rare case of a type II aneurysmal IPSVS treated percutaneously by embolization with a tissue adhesive solution.…”