uses cookies to improve your experience on the site. Your continued use of the site constitutes your acceptance of use of cookies on this site.
Find out more about how SonoWorld uses cookies. I’m OK with Cookies from SonoWorld - stop showing me this banner.
189,633 Registered Members as of 11/30/2021.
Abdomen » Liver & Biliary System
Patent paraumbilical shunt
« Back to Listing
Author(s) :
Chaitali Shah, FRCR
Presentation A cirrhotic patient presented for surveillance ultrasound after undergoing an interventional procedure to relieve his symptoms.
Caption: Oblique scan of the liver.
Description: The liver shows a coarse echotexture with a nodular surface and poor through transmission of sound. These findings are consistent with changes of cirrhosis. Also noted is ascitic fluid surrounding the liver.
Caption: Oblique image at the inferior part of the liver.
Description:  In a more medial plane, a large anechoic channel is seen coursing from the porta hepatis toward the anterior abdominal wall.
Caption: Oblique scan in the right hypochondrium.
Description: In an oblique plane through the right upper quadrant a shunt tube is identified within the previously seen venous channel. The round structure at the bottom of the image is the distended gallbladder floating in ascitic fluid.
Caption: Color Doppler image of the tubular structure.
Description: Color Doppler indicates flow within the shunt.
Caption: Transverse color Doppler image of the tubular structure.
Description: In this transverse image of the shunt there is complete wall to wall filling of color, suggesting that it is patent.
Caption: Spectral Doppler display of flow within the tubular structure.
Description: A venous waveform is recorded from the color- filled anechoic channel.
Differential Diagnosis Patent shunt through the recanalized paraumbilical vein.
Final Diagnosis Patent shunt through the recanalized paraumbilical vein.
Discussion The paraumbilical vein is a venous collateral channel that opens up in patients with cirrhosis and portal hypertension. It is a potential site for porto-systemic anastomosis. The recanalized paraumbilical vein courses in the falciform ligament and joins the superficial veins of the anterior abdominal wall [caput medusae].

This case has been discussed here to demonstrate the placement of a shunt tube in the recanalized paraumbilical vein [which is not very commonly done], in order to reduce the portal hypertension.
Case References

C Morin, M Lafortune, et al. Patent paraumbilical vein: anatomic and hemodynamic variants and their clinical importance.Radiology,1992. Vol 185, 253-256.

Other contents by this Author