Malformación de Abernethy: shunt portosistémico congénito

A 20-year-old patient came to our emergency department due to abdominal pain that had been progressing over the previous 72 h in association with vomiting and liquid stools. Physical examination and lab work showed no significant alterations. Abdominal CT, MRI (Fig. 1) and liver ultrasound identified a large varicose dilatation of the inferior mesenteric vein (IMV) with a mesenterichypogastric shunt. The IMV (Fig. 1) showed inverted flow and there were no intraor extrahepatic portal branches. Abernethy malformation is the congenital absence of the portal vein with secondary caval-mesenteric shunt. There are 2 types: type I, which is an end-to-side shunt (total absence of intrahepatic portal flow); and type II, which is a side-to-side shunt (partially preserved portal flow). Diagnosis: Abernethy malformation. c i r e s p . 2 0 1 5 ; 9 3 ( 3 ) : e 1 7