title: Congenital portosystemic shunt: our experience.
abstract: Introduction. Congenital portosystemic venous malformations are rare abnormalities in which the portal blood drains into a systemic vein and which are characterized by extreme clinical variability. Case Presentations. The authors present two case reports of a congenital extrahepatic portosystemic shunt (Type II). In the first patient, apparently nonspecific symptoms, such as headache and fatigue, proved to be secondary to hypoglycemic episodes related to the presence of a portosystemic shunt, later confirmed on imaging. During portal vein angiography, endovascular embolization of the portocaval fistula achieved occlusion of the anomalous venous tract. In the second patient, affected by Down's syndrome, the diagnosis of a portosystemic malformation was made by routine ultrasonography, performed to rule out concurrent congenital anomalies. Because of the absence of symptoms, we chose to observe this patient. Conclusions. These two case reports demonstrate the clinical heterogeneity of this malformation and the need for a multidisciplinary approach. As part of a proper workup, clinical evaluation must always be followed by radiographic diagnosis.
authors.affiliation: Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Via Santa Sofia, 95123 Catania, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Timpanaro
authors.affiliation: Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Via Santa Sofia, 95123 Catania, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Passanisi
authors.affiliation: Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Via Santa Sofia, 95123 Catania, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sauna
authors.affiliation: Radiodiagnostic and Oncological Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia, 95123 Catania, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Trombatore
authors.affiliation: Radiodiagnostic and Oncological Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia, 95123 Catania, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Pennisi
authors.affiliation: Radiodiagnostic and Oncological Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia, 95123 Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Petrillo
authors.affiliation: Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Via Santa Sofia, 95123 Catania, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Smilari
authors.affiliation: Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Via Santa Sofia, 95123 Catania, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Greco