Persisting pulmonary opacification caused by a portopulmonary shunt in a patient with portal vein thrombosis

Portopulmonary venous anastomosis are a very rare complication of chronic l iver diseases. We report on a thrombosis of the portal vein who underwent a ntibiotic patient with a cryptogenic liver cirrhosis and thrombosis treatme nt because of recurrent pneumonias several times. Although treated successf ully a pulmonal infiltrate persisted in further radiologic controls. By means of a velocity-encoded MRI a portopulmonary shunt of 30% of the car diac output was assured. An operative correction with a distal splenorenal shunt was performed successfully. Former reports of portopulmonary anastomoses complicating chronic liver dis ease never were hemodynamically relevant. In the presented case, a portopul monary anastomosis lead to recurrent pneumonias and a restrictive ventilato ry disorder.