EXTRAHEPATIC PORTOSYSTEMIC VENOUS SHUNT WITHOUT PORTAL-HYPERTENSION

A 72-year-old woman was admitted for recurrent episodes of encephalopa thy. Laboratory data showed mild liver dysfunction and hyperammonemia, while she had neither anemia nor splenomegaly. The dilated inferior m esenteric vein (IMV) was opacified retrogradely from the superior mese nteric vein by superior mesenteric arteriography, and IMV was found to connect with the inferior vena cava (IVC) through a torturous shunt. No obstruction of the extrahepatic portal vein or hepatic vein was obs erved by arteriography. Histological evaluation of the liver biopsy in dicated remarkable fatty change without cirrhosis. Finally, we diagnos ed this case as extrahepatic portosystemic venous shunt without portal hypertension.