Inferior mesenteric veno-caval shunt: imaging features and interventional treatment.
OBJECTIVE
To describe the imaging features of inferior mesenteric vein (IMV)-inferior vena cava (IVC) shunts, and to describe a treatment strategy for portosystemic encephalopathy, which can be caused by them.


METHODS
Between 2000 and 2004, we treated seven patients who had symptomatic IMV-IVC shunts. The results of imaging investigations, which included contrast-enhanced computed tomography (CT), angiography, and CT during arterial portography, were reviewed retrospectively. We also present our results in the four patients who were treated by retrograde transcaval obliteration (RTCO).


RESULTS
The IMV-IVC shunts had a tortuous or cirsoid appearance ranging in size from 7.2-14.6 mm. The shunts were located at a level near to the first branch of the inferior mesenteric artery. The four patients were successfully treated by RTCO and their clinical symptoms improved.


CONCLUSIONS
IMV-IVC shunts show a tortuous or cirsoid appearance, connecting at or near the first branch of the inferior mesenteric artery. For symptomatic IMV-IVC shunts, RTCO is recommended as the first choice treatment.
Matsumoto
S
S
Oita University Faculty of Medicine, Department of Radiology, Oita, Japan. matsushu@med.oita-u.ac.jp
Mori
H
H
Sagara
Y
Y
Kiyosue
H
H
Tanoue
S
S
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008875:Middle Aged; D011168:Portal System / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D011172:Portography / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging*; D014656:Vascular Surgical Procedures / Q000379:methods; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000000981:diagnostic imaging