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Published in: BMC Medical Imaging 1/2015

Open Access 01-12-2015 | Case report

Significance of CT scan and color Doppler duplex ultrasound in the assessment of Abernethy malformation

Authors: Lucas Souto Nacif, Denise Cerqueira Paranaguá-Vezozzo, Flávio Henrique Ferreira Galvão, Manoel S. Rocha, Wellington Andraus, Flair Jose Carrilho, Luiz Carneiro D´Albuquerque

Published in: BMC Medical Imaging | Issue 1/2015

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Abstract

Background

Abernethy malformation is a rare congenital vascular abnormality in which the portal vein bypasses the liver and drains directly into the inferior vena cava. Diagnosis is complex and requires good quality imaging methods to identify details in systemic and portal circulation in order to establish diagnostic confirmation and treatment strategy. In this study we highlight the significance of the use of CT scans and Color Doppler Duplex Ultrasound for the diagnosis, treatment and evolution assessment in two adults with Abernethy malformation.

Case presentation

The diagnosis and the treatment of two patients with Abernethy malformation by CT scan and Color Doppler Duplex Ultrasound is described. One patient was submitted to liver transplantation due to chronic liver disease and multiple nodules diagnosed as adenoma. The other patient had normal liver function and a mild neurological and psychomotor dysfunction, therefore we adopted clinical treatment and close liver parenchyma evaluation and nodule surveillance, using an imaging approach involving intercalating CT scan and Color Doppler Duplex Ultrasound every 6 months. We highlight some important direct and indirect findings of non-invasive imaging methods.

Conclusion

Abernethy malformation requires meticulous image diagnosis to improve treatment and avoid iatrogenic procedures. CT scans and Color Doppler Duplex Ultrasound are both efficient methods for diagnosis, treatment planning and evolution assessment of patients with Abernethy malformation.
Literature
1.
go back to reference Howard ER, Davenport M. Congenital extrahepatic portocaval shunts--the Abernethy malformation. J Pediatr Surg. 1997;32(3):494–7.CrossRefPubMed Howard ER, Davenport M. Congenital extrahepatic portocaval shunts--the Abernethy malformation. J Pediatr Surg. 1997;32(3):494–7.CrossRefPubMed
2.
go back to reference Loomba RS, Telega GW, Gudausky TM. Type 2 Abernethy malformation presenting as a portal vein-coronary sinus fistula. J Pediatr Surg. 2012;47(5):E25–31.CrossRefPubMed Loomba RS, Telega GW, Gudausky TM. Type 2 Abernethy malformation presenting as a portal vein-coronary sinus fistula. J Pediatr Surg. 2012;47(5):E25–31.CrossRefPubMed
3.
go back to reference Schaeffer DF, Laiq S, Jang HJ, John R, Adeyi OA. Abernethy malformation type II with nephrotic syndrome and other multisystemic presentation: an illustrative case for understanding pathogenesis of extrahepatic complication of congenital portosystemic shunt. Hum Pathol. 2013;44(3):432–7.CrossRefPubMed Schaeffer DF, Laiq S, Jang HJ, John R, Adeyi OA. Abernethy malformation type II with nephrotic syndrome and other multisystemic presentation: an illustrative case for understanding pathogenesis of extrahepatic complication of congenital portosystemic shunt. Hum Pathol. 2013;44(3):432–7.CrossRefPubMed
4.
go back to reference Hao Y, Hong X, Zhao X. Congenital absence of the portal vein associated with focal nodular hyperplasia of the liver and congenital heart disease (Abernethy malformation): a case report and literature review. Oncol Lett. 2015;9(2):695–700.PubMed Hao Y, Hong X, Zhao X. Congenital absence of the portal vein associated with focal nodular hyperplasia of the liver and congenital heart disease (Abernethy malformation): a case report and literature review. Oncol Lett. 2015;9(2):695–700.PubMed
5.
go back to reference Lisovsky M, Konstas AA, Misdraji J. Congenital extrahepatic portosystemic shunts (Abernethy malformation): a histopathologic evaluation. Am J Surg Pathol. 2011;35(9):1381–90.CrossRefPubMed Lisovsky M, Konstas AA, Misdraji J. Congenital extrahepatic portosystemic shunts (Abernethy malformation): a histopathologic evaluation. Am J Surg Pathol. 2011;35(9):1381–90.CrossRefPubMed
6.
go back to reference Badea R, Serban A, Procopet B, Caraiani C, Pascu O. Education and imaging: hepatobiliary and pancreatic: Abernethy malformation-congenital portocaval shunt. J Gastroenterol Hepatol. 2012;27(12):1875.CrossRefPubMed Badea R, Serban A, Procopet B, Caraiani C, Pascu O. Education and imaging: hepatobiliary and pancreatic: Abernethy malformation-congenital portocaval shunt. J Gastroenterol Hepatol. 2012;27(12):1875.CrossRefPubMed
7.
go back to reference Morgan G, Superina R. Congenital absence of the portal vein: two cases and a proposed classification system for portasystemic vascular anomalies. J Pediatr Surg. 1994;29(9):1239–41.CrossRefPubMed Morgan G, Superina R. Congenital absence of the portal vein: two cases and a proposed classification system for portasystemic vascular anomalies. J Pediatr Surg. 1994;29(9):1239–41.CrossRefPubMed
8.
go back to reference Van Beers BE, Daire JL, Garteiser P. New imaging techniques for liver diseases. J Hepatol. 2015;62(3):690.CrossRefPubMed Van Beers BE, Daire JL, Garteiser P. New imaging techniques for liver diseases. J Hepatol. 2015;62(3):690.CrossRefPubMed
Metadata
Title
Significance of CT scan and color Doppler duplex ultrasound in the assessment of Abernethy malformation
Authors
Lucas Souto Nacif
Denise Cerqueira Paranaguá-Vezozzo
Flávio Henrique Ferreira Galvão
Manoel S. Rocha
Wellington Andraus
Flair Jose Carrilho
Luiz Carneiro D´Albuquerque
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2015
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/s12880-015-0079-7

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