Korean J Transplant.  2022 Dec;36(4):298-301. 10.4285/kjt.22.0022.

Portal vein fenestration: a case report of an unusual portal vein developmental anomaly

• Balradja I
• Har B
• Rastogi R
• Agarwal S
• Gupta S

• KMID: 2537543
• DOI: http://doi.org/10.4285/kjt.22.0022

Abstract

Portal vein anatomic variations are common in living donor liver transplantation. Portal vein fenestration, in which a segment of a vessel divides into at least two channels that reunite into a single distal lumen, has not yet been reported in the literature. Failure to identify this anomaly can lead to catastrophic events in donor liver hepatectomy. Herein, we report an unusual portal vein anomaly that was detected intraoperatively in a living liver donor.

Keyword

Portal vein; Anomaly; Living donor; Case report

Figure

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  Fig. 1 (A) Schematic illustration of type C portal vein (PV) with PV fenestration in the PV trunk below the confluence of the right anterior PV (RAPV) and left PV (LPV). (B) Intraoperative photograph showing PV fenestration. RPPV, right posterior PV; MPV, main PV.

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  Fig. 2 (A) Schematic representation of wrongly looped right portal vein. (B) Wrong division of right portal vein compromising the remnant liver portal flow. RPPV, right posterior portal vein; RAPV, right anterior portal vein; LPV, left portal vein; MPV, main portal vein.

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  Fig. 3 (A, B) Schematic illustration of the right anterior portal vein (RAPV) and right posterior portal vein (RPPV) looped separately and divided. (C) Intraoperative photograph showing the closed stumps of the RAPV and RPPV (white arrows) and fenestration (yellow arrow). LPV, left portal vein; MPV, main portal vein.

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  Fig. 4 (A) Preoperative three-dimensional reconstruction of the portal vein in the donor where fenestration was not clearly seen. (B) Coronal oblique reformatted contrast-enhanced computed tomography scan images during the portal phase showing fenestration of the portal vein.

Reference

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