Spontaneous thrombosis of congenital extrahepatic portosystemic shunt (Abernethy malformation) simulating inguinal hernia incarceration.
Tender lumps in the inguinal region are often explored emergently to treat suspected hernial strangulation. We discuss the case of an adult male who presented acutely with a tender inguinal swelling and raised inflammatory markers and was therefore deemed as requiring surgical exploration. However preoperative abdominal computerized tomography (CT) revealed an extensive thrombosing congenital venous malformation of portosystemic origin with extension into the symptomatic inguinal canal. A potentially lethal exsanguination from surgery was thus avoided.
Afzal
Samara
S
Department of Vascular Surgery, Russells Hall Hospital, Dudley, West Midlands, United Kingdom.
Nair
Amit
A
Grainger
Jennie
J
Latif
Sherif
S
Rehman
Atiq-ur
AU
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001401:Azygos Vein / Q000002:abnormalities; D003937:Diagnosis, Differential; D006552:Hernia, Inguinal / Q000175:diagnosis*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D010690:Phlebography; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin