A basic understanding of congenital extrahepatic portosystemic shunt: incidence, mechanism, complications, diagnosis, and treatment.

Extrahepatic portosystemic shunt belongs to a family of rare vascular abnormalities. The clinical importance and manifestations of this vascular abnormality range from asymptomatic cases to liver or metabolic dysfunctions of various degrees. Congenital extrahepatic portosystemic shunt, also termed as Abernethy malformation, is a very rare congenital vascular malformation in which splenomesenteric blood drains into a systemic vein, bypassing the liver through a complete or partial extrahepatic shunt. So far, limited cases of congenital extrahepatic portosystemic shunt have been reported. In this review, incidence, mechanisms, complications, diagnoses and treatments of congenital extrahepatic portosystemic shunt are described.

[1]  F. Nevens,et al.  Congenital Extrahepatic Portosystemic Shunts (Abernethy Malformation): An International Observational Study , 2020, Hepatology.

[2]  S. Harikrishnan,et al.  Congenital extrahepatic portosystemic shunt with progressive myelopathy and encephalopathy , 2019, Practical Neurology.

[3]  S. Tavri,et al.  Role of interventional radiology in the diagnosis and management of congenital extrahepatic portosystemic shunts: Two case reports , 2019, The Indian journal of radiology & imaging.

[4]  M. Pompili,et al.  Congenital extrahepatic portosystemic shunt: description of four cases and review of the literature , 2018, Journal of Ultrasound.

[5]  N. Heaton,et al.  Congenital portosystemic venous shunt , 2017, European Journal of Pediatrics.

[6]  P. Song,et al.  The clinical management of hepatocellular carcinoma worldwide: A concise review and comparison of current guidelines from 2001 to 2017. , 2017, Bioscience trends.

[7]  A. Aziz,et al.  Incidental radiological diagnosis of asymptomatic Abernethy malformations—two case reports , 2016, BJR case reports.

[8]  Richard J. Thompson,et al.  Case Report: Multiple beta-catenin mutations in hepatocellular lesions arising in Abernethy Malformation , 2016 .

[9]  N. Heaton,et al.  Liver resection for the treatment of a congenital intrahepatic portosystemic venous shunt. , 2016, Hepatobiliary & pancreatic diseases international : HBPD INT.

[10]  M. Rodriguez-Davalos,et al.  Congenital Extrahepatic Portosystemic Shunt (Abernethy Malformation Type Ib) with Associated Hepatocellular Carcinoma: Case report and Literature Review. , 2016, Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society.

[11]  Ying Guo,et al.  Congenital extrahepatic portosystemic shunt: an underdiagnosed but treatable cause of hepatopulmonary syndrome , 2016, European Journal of Pediatrics.

[12]  B. Tarlatzis,et al.  Prenatal diagnosis of Abernethy malformation by three‐dimensional ultrasonography , 2015, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[13]  N. Heaton,et al.  Congenital extrahepatic portosystemic shunt complicated by the development of hepatocellular carcinoma. , 2015, Hepatobiliary & pancreatic diseases international : HBPD INT.

[14]  H. Haboubi,et al.  Congenital extrahepatic portosystemic shunt. , 2015, British journal of hospital medicine.

[15]  M. Kasahara,et al.  The classification based on intrahepatic portal system for congenital portosystemic shunts. , 2015, Journal of pediatric surgery.

[16]  M. Pennisi,et al.  Congenital Portosystemic Shunt: Our Experience , 2015, Case reports in pediatrics.

[17]  wenhui zhang,et al.  Characterization of uncommon portosystemic collateral circulations in patients with hepatic cirrhosis , 2014, Oncology letters.

[18]  G. Maddern,et al.  Systematic review of congenital and acquired portal‐systemic shunts in otherwise normal livers , 2014, The British journal of surgery.

[19]  H. Youn,et al.  A Case of Pulmonary Arterial Hypertension Associated with Congenital Extrahepatic Portocaval Shunt , 2014, Journal of Korean medical science.

[20]  C. Sokollik,et al.  Congenital Portosystemic Shunt: Characterization of a Multisystem Disease , 2013, Journal of pediatric gastroenterology and nutrition.

[21]  D. Pariente,et al.  Congenital Portosystemic Shunts in Children: Recognition, Evaluation, and Management , 2012, Seminars in Liver Disease.

[22]  T. Blanc,et al.  Congenital portosystemic vascular malformations. , 2012, Seminars in pediatric surgery.

[23]  S. Uemoto,et al.  The Role of Liver Transplantation for Congenital Extrahepatic Portosystemic Shunt , 2012, Transplantation.

[24]  N. Agarwal,et al.  Abernethy malformation: a case report , 2012, BMC Pediatrics.

[25]  Y. Kawano,et al.  The role of operative intervention in management of congenital extrahepatic portosystemic shunt. , 2012, Surgery.

[26]  W. Kim,et al.  Clinical features of congenital portosystemic shunt in children , 2012, European Journal of Pediatrics.

[27]  S. Digumarthy,et al.  Congenital portosystemic shunts: imaging findings and clinical presentations in 11 patients. , 2011, European journal of radiology.

[28]  J. Misdraji,et al.  Congenital Extrahepatic Portosystemic Shunts (Abernethy Malformation): A Histopathologic Evaluation , 2011, The American journal of surgical pathology.

[29]  L. Hierro,et al.  Clinical and radiologic manifestations of congenital extrahepatic portosystemic shunts: a comprehensive review. , 2011, Radiographics : a review publication of the Radiological Society of North America, Inc.

[30]  S. Yagel,et al.  Shunt diameter in agenesis of the ductus venosus with extrahepatic portosystemic shunt impacts on prognosis , 2011, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[31]  R. Superina,et al.  Management and classification of type II congenital portosystemic shunts. , 2011, Journal of pediatric surgery.

[32]  F. Barchetti,et al.  Congenital absence of the portal vein in a middle-aged man , 2011, Surgical and Radiologic Anatomy.

[33]  E. Hiyama,et al.  Surgical intervention for patent ductus venosus , 2010, Pediatric Surgery International.

[34]  J. Riou,et al.  Complications of Congenital Portosystemic Shunts in Children: Therapeutic Options and Outcomes , 2010, Journal of pediatric gastroenterology and nutrition.

[35]  M. Kuo,et al.  Exploiting phenotypic plasticity for the treatment of hepatopulmonary shunting in Abernethy malformation. , 2010, Journal of vascular and interventional radiology : JVIR.

[36]  H. Kirikoshi,et al.  Clinical classification of congenital extrahepatic portosystemic shunts , 2010, Hepatology research : the official journal of the Japan Society of Hepatology.

[37]  F. Cacciapaglia,et al.  Portosystemic shunts in a large cohort of patients with liver cirrhosis: detection rate and clinical relevance , 2009, Journal of Gastroenterology.

[38]  Guo-Hua Hu,et al.  Insight into congenital absence of the portal vein: is it rare? , 2008, World journal of gastroenterology.

[39]  K. Ihara,et al.  Pulmonary Hypertension in Patients With Congenital Portosystemic Venous Shunt: A Previously Unrecognized Association , 2008, Pediatrics.

[40]  N. Kawashima,et al.  Resolution of hepatopulmonary syndrome after ligation of a portosystemic shunt in a pediatric patient with an Abernethy malformation. , 2008, Journal of pediatric surgery.

[41]  R. Arnon,et al.  Resolution of hepatopulmonary syndrome after auxiliary partial orthotopic liver transplantation in abernethy malformation. A case report , 2007, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[42]  A. Galindo,et al.  Diagnosis of Absent Ductus Venosus in a Population Referred for Fetal Echocardiography , 2007, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[43]  M. Kasahara,et al.  Successful liver transplantation for congenital absence of the portal vein complicated by intrapulmonary shunt and brain abscess. , 2005, Journal of pediatric surgery.

[44]  M. Fukuzawa,et al.  Laparoscopic Correction of Congenital Portosystemic Shunt in Children , 2004, Surgical laparoscopy, endoscopy & percutaneous techniques.

[45]  K. Lakhoo,et al.  Prenatally diagnosed portocaval shunt and postnatal outcome: a case report , 2004, Prenatal diagnosis.

[46]  P. Pratt,et al.  Polysplenia with pulmonary arteriovenous malformations , 1993, Pediatric Cardiology.

[47]  Paul S. Babyn,et al.  Congenital extrahepatic portosystemic shunts , 2003, Pediatric Radiology.

[48]  J. Ribeiro,et al.  Abernethy malformation: One of the etiologies of hepatopulmonary syndrome , 2002, Pediatric pulmonology.

[49]  Shogo Fujita,et al.  Congenital absence of the portal vein and role of liver transplantation in children. , 2001, Journal of pediatric surgery.

[50]  K. Murphy,et al.  Congenital absence of portal vein in the fetus: a case report , 2001, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[51]  F. Endo,et al.  The long-term prognosis of congenital portosystemic venous shunt. , 1999, The Journal of pediatrics.

[52]  G. Altavilla,et al.  Ultrastructural analysis of the liver with portal vein agenesis: a case report. , 1998, Ultrastructural pathology.

[53]  N. Sakura,et al.  Elevated plasma bile acids in hypergalactosaemic neonates: a diagnostic clue to portosystemic shunts , 1997, European Journal of Pediatrics.

[54]  G. Morgan,et al.  Congenital absence of the portal vein: two cases and a proposed classification system for portasystemic vascular anomalies. , 1994, Journal of pediatric surgery.

[55]  Donald D. Trljnke The Rôle of the "Liver." , 1900, The Hospital.

[56]  J. Abernethy Account of Two Instances of Uncommon Formation in the Viscera of the Human Body , 1793, Philosophical Transactions of the Royal Society of London.