Related Experiment Video
Updated: Apr 6, 2026
New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
Published on: June 27, 2025
Congenital portosystemic shunts with and without gastrointestinal bleeding - case series
Ying Gong1, Hui Zhu2, Jun Chen1
1Department of Radiology, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
Insights
Congenital portosystemic shunts can present with gastrointestinal bleeding, often associated with extrahepatic shunts draining into the iliac vein. This specific shunt type, though uncommon, shows a high rate of bleeding in children.
Area of Science:
- Pediatric Radiology
- Vascular Anomalies
- Gastroenterology
Background:
- Congenital portosystemic shunts (CPSS) present variably.
- Gastrointestinal bleeding is an uncommon manifestation of CPSS.
Purpose of the Study:
- To detail the imaging characteristics of CPSS.
- To correlate imaging findings with the presence or absence of gastrointestinal bleeding in pediatric patients.
Main Methods:
- Retrospective analysis of clinical and imaging data.
- Inclusion of 11 children diagnosed with CPSS.
- Categorization based on presence (n=6) or absence (n=5) of gastrointestinal bleeding.
Main Results:
- Seven extrahepatic and four intrahepatic shunts identified.
- Gastrointestinal bleeding cases predominantly showed extrahepatic shunts from splenomesenteric junction or splenic vein to internal iliac vein (n=6).
- Non-bleeding cases included one extrahepatic and four intrahepatic shunts.
Conclusions:
- Extrahepatic shunts draining portal blood via the inferior mesenteric vein to the iliac vein are linked to gastrointestinal bleeding in CPSS.
- This specific shunt anatomy is rare but carries a high risk of gastrointestinal bleeding.
Background:
The clinical presentation of congenital portosystemic shunt is variable and gastrointestinal bleeding is an uncommon presentation.
Objective:
To describe the imaging features of congenital portosystemic shunt as it presented in 11 children with (n = 6) and without gastrointestinal bleeding (n = 5).
Materials And Methods:
We performed a retrospective study on a clinical and imaging dataset of 11 children diagnosed with congenital portosystemic shunt.
Results:
A total of 11 children with congenital portosystemic shunt were included in this study, 7 with extrahepatic portosystemic shunts and 4 with intrahepatic portosystemic shunts. Six patients with gastrointestinal bleeding had an extrahepatic portosystemic shunt, and the imaging results showed that the shunts originated from the splenomesenteric junction (n = 5) or splenic vein (n = 1) and connected to the internal iliac vein. Among the five cases of congenital portosystemic shunt without gastrointestinal bleeding, one case was an extrahepatic portosystemic shunt and the other four were intrahepatic portosystemic shunts.
Conclusion:
Most congenital portosystemic shunt patients with gastrointestinal bleeding had a shunt that drained portal blood into the iliac vein via an inferior mesenteric vein. This type of shunt was uncommon, but the concomitant rate of gastrointestinal bleeding with this type of shunt was high.
More Related Videos
12:27Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt
Published on: May 7, 2015
04:00Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Related Concept Videos
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
01:24Esophageal Varices-I: Introduction