Year 2019 / Volume 111 / Number 9
Case Report
Appreciation of the treatment in adult patients with congenital portosystemic connections in relation with their symptoms

714-716

DOI: 10.17235/reed.2019.6210/2019

Ramón Gómez Contreras, Amalia Talens Ferrando, Juan Carlos Bernal Sprekelsen, Francisco Javier Landete Molina, Cristóbal Zaragoza Fernández,

Abstract
Background: portosystemic intrahepatic venous connections (Abernethy syndrome) are rare anatomical variants, which are classified according to the type of union between the portal venous circulation and the central venous system. In adults, the diagnosis is often incidental, although some cases can be presented with an encephalopathy without associated liver disease. Case reports: here we present two cases of portosystemic shunt, one with encephalopathy development, and the other casually caught. Its treatment by interventionist radiology, was decided in function of clinic symptoms. Both patients were asymptomatic at controls in the outpatient consultation. No complications derived from the therapeutic decision. The control is carried out annually with image tests and blood analysis. Discussion: given the low prevalence of malformation and its usual diagnosis at younger ages (associated with important cognitive alterations) its treatment in adults is not protocolized. In these cases the decision of the treatment would be conditioned to the associated symptomatology, being the minimally invasive treatment (by interventional radiology) a therapeutic option in the symptomatic adult. Observation by imaging tests and control in outpatient consultation (without associated treatment) would be a choice in asymptomatic adults.
Share Button
New comment
Comments
No comments for this article
References
1. Tanoue S, Kiyosue H, Komatsu E, Hori Y, Maeda T, Mori H. Symptomatic intrahepatic portosystemic venous shunt: angiographic findings and transcatheter embolization with an alternative approach. AJR 2003; 181:71–78.
2. Ito K, Matsunaga N, Mitchell DG et al. Imaging of congenital abnormalities of the portal venous system. AJR Am J Roentgenol 1997; 168:233-237.
3. Gallego C, Velasco M, Marcuello P, Tejedor D, De Campo L, Friera A. Congenital and acquired anomalies of the portal venous system. Radiographics 2002; 22:141-159.
4. Gallego C, Miralles M, Marín C, Muyor P, Gonzaléz G, García-Hidalgo E. Congenital hepatic shunts. Radiographics 2004; 24:755-772.
5. Corness JAG, McHugh K, Roebuck DJ, Taylor AM. The portal vein in children: radiological review of congenital anomalies and acquired abnormalities. Pediatr Radiol 2006; 36:87–96.
6. Santos L, Nobre S, Laezza N, Cunha C, Gonçalves I, Lopes MF. Congenital shunts of the portal venous system: Case-series of uncommon shunts. Ann Hepatol , 2017; 16(6):941-949.
7- Park JH, Cha Sh, Han JK et al. Intrahepaatic portosystemic venous shunt. AJR 1990; 155(3):527-528.
8. Jabra AA, Taylor GA. Ultrasound diagnosis of congenital intrahepatic portosystemic venous shunt. Pediatr Radiol 1991; 21(7): 529-30.
9. Crespo L, Graus J, García-Hoz F, Bárcena R, Gil Grande L, Moreira VF, Milicua JM, Sánchez J, Blázquez J. Encefalopatía hepática secundaria a la existencia de un shunt portosistémico tratada satisfactoriamente mediante radiología intervencionista. Rev Esp Enferm Dig 2007; 99: 667-670.
10. Evans WN, Galindo A, Acherman RJ, Rothman A, Berthoty DP. Congenital portosystemic shunts and AMPLATZER Vascular Plug occlusion in newborns. Pediatr Cardiol 2009; 30:1083–1088.
Related articles

Letter

Abernethy syndrome as a cause of liver transplantation

DOI: 10.17235/reed.2024.10561/2024

Editorial

Diagnosis and management of Abernethy syndrome

DOI: 10.17235/reed.2023.9781/2023

Letter

Capecitabine-induced hyperammonemic encephalopathy

DOI: 10.17235/reed.2021.8129/2021

Digestive Diseases Image

Percutaneous treatment of a splenorenal shunt with an atrial septal closure device

DOI: 10.17235/reed.2020.7701/2020

Letter to the Editor

STOMAL VARICES: AN UNUSUAL CAUSE OF BLEEDING IN PATIENTS WITH PORTAL HYPERTENSION

DOI: 10.17235/reed.2015.3707/2015

Citation tools
Gómez Contreras R, Talens Ferrando A, Bernal Sprekelsen J, Landete Molina F, Zaragoza Fernández C. Appreciation of the treatment in adult patients with congenital portosystemic connections in relation with their symptoms. 6210/2019


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1009 visits.
This article has been downloaded 154 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 04/02/2019

Accepted: 07/03/2019

Online First: 23/07/2019

Published: 05/09/2019

Article Online First time: 169 days

Article editing time: 213 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2024 y Creative Commons. The Spanish Journal of Gastroenterology