Abnormal direct entry of the umbilical vein into the portal vein: report of a case.
Abnormalities of the intra-abdominal umbilical venous connections are rare congenital vascular anomalies. We report a case of an aneurismal dilatation of an umbilical vein directly connected to the portal vein, vital for the delivery of placental blood in the fetus. A term female newborn presented with a dilated umbilical vein detected by prenatal ultrasound. CT angiography revealed an aneurismal dilatation of a vascular structure, from the umbilical ring to the main portal vein. Follow-up CT angiography showed thrombus progression up to the level of SMV inlet. A laparotomy revealed that the normal course of the umbilical vein was absent. The aneurysm was resected and no thrombus was noted in the aneurysm. Post-operative ultrasound revealed an isolated thrombus at the right main portal vein that resolved spontaneously on the follow-up ultrasound. At the 6-month post-operative follow-up, the baby was well and without complications. Although not evaluated for the presence of a ductus venosus, this anomalous umbilical-portal venous connection might have been associated with an absent ductus venosus.
Moon
Suk-Bae
SB
Department of Pediatric Surgery, Seoul National University Children's Hospital, 28 Youngon-dong, Chongno-gu, Seoul, 110-744, South Korea. medica95@medimail.co.kr
Park
Kwi-Won
KW
Jung
Sung-Eun
SE
D000783:Aneurysm / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011169:Portal Vein / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed; D016216:Ultrasonography, Prenatal; D014471:Umbilical Veins / Q000002:abnormalities*
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