An Adult Case of Congenital Extrahepatic Portosystemic Shunt Successfully Treated with Balloon-occluded Retrograde Transvenous Obliteration
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- Tanaka Hironori
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Saijo Yoshihito
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Tomonari Tetsu
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Tanaka Takahiro
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Taniguchi Tatsuya
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Yagi Shusuke
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Okamoto Koichi
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Miyamoto Hiroshi
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Sogabe Masahiro
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Sato Yasushi
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Muguruma Naoki
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Tsuneyama Koichi
- Department of Pathology and Laboratory Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Sata Masataka
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Japan
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- Takayama Tetsuji
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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Abstract
<p>A 42-year-old woman visited our hospital due to syncope. Contrast-enhanced CT revealed portosystemic shunt, portal vein hypoplasia, and multiple liver nodules. The histological examination of a liver biopsy specimen exhibited portal vein hypoplasia and revealed that the liver tumor was positive for glutamine synthetase. The patient was therefore diagnosed with congenital extrahepatic portosystemic shunt type II, and with focal nodular hyperplasia (FNH)-like nodules. She had the complication of severe portopulmonary hypertension and underwent complete shunt closure by balloon-occluded retrograde transvenous obliteration (B-RTO). The intrahepatic portal vein was well developed at 1 year after B-RTO, and multiple liver nodules completely regressed. Her pulmonary hypertension also improved. </p>
Journal
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- Internal Medicine
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Internal Medicine 60 (12), 1839-1845, 2021-06-15
The Japanese Society of Internal Medicine
