ArticleFrontiers in pediatrics2026
Endovascular closure of a large intrahepatic portosystemic shunt in a three-month-old infant: a case report and literature review.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Congenital portosystemic shunts (CPSS) are rare vascular anomalies characterized by partial or complete diversion of portal blood into the systemic circulation, bypassing hepatic filtration. Early recognition and timely intervention are crucial to prevent severe metabolic and developmental complications. Case presentation: We report a rare case of a three-month-old male infant presenting with persistent jaundice and growth retardation. Laboratory tests revealed marked hyperbilirubinemia (316 µmol/L) and elevated transaminase levels (ALT 944 U/L, AST 405 U/L). Doppler ultrasonography and contrast-enhanced CT demonstrated a large intrahepatic portosystemic shunt (up to 25 mm in diameter) with hypoplasia of the right hepatic lobe. Following multidisciplinary team discussion, endovascular coil embolization was performed via a transjugular approach. An early postoperative complication occurred due to coil migration into the pulmonary artery, which was successfully managed with endovascular retrieval. The patient showed rapid normalization of liver function tests, restoration of portal blood flow, and catch-up growth during follow-up. Conclusion: This case highlights the feasibility, safety, and effectiveness of endovascular closure of large intrahepatic CPSS even in very young infants. It underscores the critical importance of thorough anatomical evaluation, multidisciplinary planning, and meticulous postoperative monitoring to ensure optimal outcomes and to promptly address potential complications.
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