We present a case of congenital intrahepatic aneurysmal portosystemic shunt in which the right portal vein communicates with both a variant inferior right hepatic vein and the right hepatic vein. We also describe the importance and efficacy of three dimensional computed tomography reconstruction images in determining subtle, small shunt vessels.

of end stage liver disease has been signifi cantly improved. For example, we do now much better understand hyperdynamic circulation of liver failure, hepatorenal syndrome and its consequences, the role of TIPSS (transjugular intrahepatic portosystemic shunt) and adrenal insuffi ciency in liver failure patients. The management and prophylaxis of variceal bleeding and subacute bacterial peritonit...

Transjugular intrahepatic portosystemic shunt (TIPS) is a new treatment modality in patients of intractable ascites with Budd-Chiari syndrome. We report a young lady who presented with intractable ascites and encephalopathy and diagnosed to have Budd-Chiari syndrome. She was treated with TIPS and on follow-up after 12 months she is free of ascites, encephalopathy and able to perform her daily w...

Key Points: • Various advanced imaging modalities may be used to diagnose extrahepatic portosystemic shunts (PSS), including ultrasound, transsplenic scintigraphy, computed tomography (CT) and magnetic resonance imaging (MRI), each with unique advantages and disadvantages. • CT angiography provides the best detail of overall shunt anatomy and is also helpful in rechecking patients with persiste...

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