Portohepatic Venous Shunt

Although intrahepatic portal-systemic (hepatic) venous shunt had been thought to be a rare disease, recent advances in ultrasound, CT, and MRI have made it possible to depict this condition in an increasing number of patients67-69 (Figs. 2-39 and 2-40). A high degree of shunt may produce hepatic encephalopathy due to hy-perammonemia. Single or multiple shunts may be present, and there may be other anomalies such as membranous obstruction of the IVC.70 It has recently been reported that hepatic adenoma, hepatocellular carcinoma, or nodular hyperplasia may develop in the ische-mic liver in the presence of portosystemic shunts.71,72

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