Abernethy syndrome presenting as an incidentally detected intrahepatic portosystemic shunt in an infant
DOI:
https://doi.org/10.37609/srinmed.58Keywords:
Abernethy syndrome, portosystemic shunt, intrahepatic shunt, spontaneous closure, portal venous anomaly, congenital shunt, vascular malformationAbstract
Abernethy syndrome is a rare congenital anomaly in which blood from the splanchnic venous system partially or completely bypasses the liver through a portosystemic shunt and enters the systemic circulation. A subset of patients remains asymptomatic and are diagnosed incidentally, while others may present with complications such as portopulmonary hypertension, hepatopulmonary syndrome, portosystemic encephalopathy, or hepatic tumors. Early identification is important, as clinical outcomes depend on the degree of shunting and the presence of complications. In this report, we describe an asymptomatic infant diagnosed during Doppler ultrasonography, with documented spontaneous closure of the intrahepatic portosystemic shunt during follow-up and discuss the case in light of current literature to highlight the importance of careful monitoring.
Downloads
References
Abernethy J. Account of Two Instances of Uncommon Formation in the Viscera of the Human Body: From the Philosophical Transactions of the Royal Society of London. Med Facts Obs. 1797;7:100–108.
Bernard O, Franchi-Abella S, Branchereau S, Pariente D, Gauthier F, Jacquemin E. Congenital portosystemic shunts in children: recognition, evaluation, and management. Semin Liver Dis. 2012;32(4):273-287. doi:10.1055/s-0032-1329896
Gitzelmann R, Forster I, Willi UV. Hypergalactosaemia in a newborn: self-limiting intrahepatic portosystemic venous shunt. Eur J Pediatr. 1997;156(9):719-722. doi:10.1007/s004310050698
Stringer MD. The clinical anatomy of congenital portosystemic venous shunts. Clin Anat. 2008;21(2):147-157. doi: 10.1002/ca.20574
Witters P, Maleux G, George C, et al. Congenital veno-venous malformations of the liver: widely variable clinical presentations. J Gastroenterol Hepatol. 2008;23(8 Pt 2):e390-e394. doi:10.1111/j.1440-1746.2007.05156.x
Sokollik C, Bandsma RH, Gana JC, van den Heuvel M, Ling SC. Congenital portosystemic shunt: characterization of a multisystem disease. J Pediatr Gastroenterol Nutr. 2013;56(6):675-681. doi:10.1097/MPG.0b013e31828b3750
Baiges A, Turon F, Simón-Talero M, et al. Congenital Extrahepatic Portosystemic Shunts (Abernethy Malformation): An International Observational Study. Hepatology. 2020;71(2):658-669. doi:10.1002/hep.30817
Jain V, Sangdup T, Agarwala S, et al. Abernethy malformation type 2: varied presentation, management and outcome. J Pediatr Surg. 2019;54(4):760-765. doi:10.1016/j.jpedsurg.2018.08.053
De Gaetano AM, Rinaldi P, Barbaro B, et al. Intrahepatic portosystemic venous shunts: Color Doppler sonography. Abdom Imaging. 2007;32(4):463-469. doi:10.1007/s00261-006-9068-1
Ponziani FR, Faccia M, Zocco MA, et al. Congenital extrahepatic portosystemic shunt: description of four cases and review of the literature. J Ultrasound. 2019;22(3):349-358. doi:10.1007/s40477-018-0329-y
Grazioli L, Alberti D, Olivetti L, et al. Congenital absence of portal vein with nodular regenerative hyperplasia of the liver. Eur Radiol. 2000;10(5):820-825. doi:10.1007/s003300051012
Hu GH, Shen LG, Yang J, Mei JH, Zhu YF. Insight into congenital absence of the portal vein: is it rare?. World J Gastroenterol. 2008;14(39):5969-5979. doi:10.3748/wjg.14.5969
Chocarro G, Amesty MV, Encinas JL, et al. Congenital Portosystemic Shunts: Clinic Heterogeneity Requires an Individual Management of the Patient. Eur J Pediatr Surg. 2016;26(1):74-80. doi:10.1055/s-0035-1566097
Franchi-Abella S, Branchereau S, Lambert V, et al. Complications of congenital portosystemic shunts in children: therapeutic options and outcomes. J Pediatr Gastroenterol Nutr. 2010;51(3):322-330. doi:10.1097/MPG.0b013e3181d9cb92
Knirsch W, Benz DC, Bühr P, et al. Catheter interventional treatment of congenital portosystemic venous shunts in childhood. Catheter Cardiovasc Interv. 2016;87(7):1281-1292. doi:10.1002/ccd.26362
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):1239-1241. doi:10.1016/0022-3468(94)90812-5
Delle Chiaie L, Neuberger P, Von Kalle T. Congenital intrahepatic portosystemic shunt: prenatal diagnosis and possible influence on fetal growth. Ultrasound Obstet Gynecol. 2008;32(2):233-235. doi:10.1002/uog.6116
Ono H, Mawatari H, Mizoguchi N, Eguchi T, Sakura N. Clinical features and outcome of eight infants with intrahepatic porto-venous shunts detected in neonatal screening for galactosaemia. Acta Paediatr. 1998;87(6):631-634. doi:10.1080/080352598750014021
Ohno T, Muneuchi J, Ihara K, et al. Pulmonary hypertension in patients with congenital portosystemic venous shunt: a previously unrecognized association. Pediatrics. 2008;121(4):e892-e899. doi:10.1542/peds.2006-3411
Weigert A, Bierwolf J, Reutter H, et al. Congenital intrahepatic portocaval shunts and hypoglycemia due to secondary hyperinsulinism: a case report and review of the literature. J Med Case Rep. 2018;12(1):336. Published 2018 Nov 12. doi:10.1186/s13256-018-1881-y
Kim MJ, Ko JS, Seo JK, et al. Clinical features of congenital portosystemic shunt in children. Eur J Pediatr. 2012;171(2):395-400. doi:10.1007/s00431-011-1564-9
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Scientific Reports in Medicine

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The Journal and content of this website is licensed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License. This is in accordance with the Budapest Open Access Initiative (BOAI) definition of open access. The Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allows users to copy, distribute and transmit unmodified article, and make noncommercial use of the article. The CC BY license permits non-commercial re-use of an open access article, as long as the author is properly attributed.