Traumatic Portacaval Shunt: A Case Report and Literature Review

Authors

  • Susanna C Spence
  • Nathaniel HP Strobel
  • Nicholas M Beckmann
  • Manickam Kumaravel

DOI:

https://doi.org/10.3941/jrcr.v7i11.1817

Keywords:

High grade liver injury, grade V liver laceration, traumatic portosystemic fistula, traumatic portacaval fistula, traumatic portosystemic shunt

Abstract

Computed tomography (CT) evaluation of the acute polytrauma patient has become well established as a mainstay of ER triage in hemodynamically stable patients. The radiologist plays a pivotal role in directing management by identifying and appropriately categorizing the severity of a patient's injuries. High-grade liver injuries have undergone an increasing trend of nonoperative management over the last several decades, with concurrent decrease in mortality. However, we present a case of a patient with a grade V liver laceration, in whom a rare portacaval shunt was also present. In the setting of this rare injury, the radiologist will likely be the first person to recognize and categorize a severe complication, which may indicate the need for a fundamental change in patient management.

Author Biographies

Susanna C Spence

Assistant Professor

Dept of Diagnostic and Interventional Imaging

Nathaniel HP Strobel

Assistant Professor

Dept of Pediatrics, Division of Critical Care

Nicholas M Beckmann

Assistant Professor

Dept of Diagnostic and Interventional Imaging

Manickam Kumaravel

Associate Professor

Dept of Diagnostic and Interventional Imaging

Published

2013-11-26

Issue

Section

Emergency Radiology