Intrahepatic Congenital Portosystemic Shunts.

Abstract

Patients with a single congenital portosystemic shunt (PSS) often fail to thrive and routinely experience episodes of hepatic encephalopathy. Although medical therapy may mitigate clinical signs, shunt attenuation improves long-term outcomes and allows for improved liver function. Intrahepatic PSSs are less common than their extrahepatic counterparts and pose some unique challenges. Minimally invasive intravascular approaches are generally recommended to treat IHPSSs with some exeptions including some patients with patent ductus venosus. Outcomes with percutaneous transvenous coil embolization are generally good, with low perioperative mortality rates and clinical improvement reported in greater than 80% of cases.