DOI: 10.12890/2022_003145

Type II Abernethy Malformation: A Rare Cause of Hepatic Encephalopathy in Adulthood

Authors

  • Inês Gonçalves Department of Internal Medicine, Hospital de Braga, Braga, Portugal
  • Daniela Barros Department of Radiology, Hospital de Braga, Braga, Portugal
  • Margarida Araújo Department of Internal Medicine, Hospital de Braga, Braga, Portugal
  • Ana Isabel Machado Department of Internal Medicine, Hospital de Braga, Braga, Portugal
  • Camila Oliveira Department of Oncology, Hospital de Braga, Braga, Portugal
  • Luisa Pinto Department of Internal Medicine, Hospital de Braga, Braga, Portugal

inesabreugoncalves@gmail.com

Keywords

Abernethy malformation, portosystemic shunt, encephalopathy, hyperammonemia

Abstract

Abernethy malformation is a rare congenital extrahepatic portosystemic shunt with variable clinical manifestations, mainly associated with the portosystemic shunt. Hepatic encephalopathy can be the first manifestation. 
We present the case of a 50-year-old woman with hepatic encephalopathy without liver dysfunction. Further evaluation with contrast-enhanced abdominal computed tomography was performed, showing a large-calibre portocaval shunt from the left portal branch, suggestive of type 2 Abernethy malformation. The patient improved with lactulose and rifaximin but maintained rare encephalopathy episodes. She is therefore currently awaiting surgical treatment. 
Despite being a rare cause of hepatic encephalopathy, Abernethy malformation should be considered in patients with unexplained hyperammonaemia. Since it is potentially reversible, and early diagnosis and treatment may improve outcome, raising awareness of this malformation is essential.

View the entire article

Downloads

References

  1. Kumar P, Bhatia M, Garg A, Jain S, Kumar K. Abernethy malformation: a comprehensive review. Diagn Interv Radiol 2021 Dec 16. doi: 10.5152/dir.2021.20474. Online ahead of print.
  2. Mesquita RD, Sousa M, Vilaverde F, Cardoso R. Abernethy malformation: beware in cases of unexplained hepatic encephalopathy in adults-case report and review of the relevant literature. BJR Case Rep 2018;4(2):20170054.
  3. Li H, Ma Z, Xie Y, Tian F. Recurrent hyperammonemia after Abernethy malformation type 2 closure: a case report. Ann Hepatol 2017;16(3):460–464.
  4. Uchino T, Matsuda I, Endo F. The long-term prognosis of congenital portosystemic venous shunt. J Pediatr 1999;135(2 Pt 1):254–256.
  5. Franchi-Abella S, Branchereau S, Lambert V, Fabre M, Steimberg C, Losay J, et al. Complications of congenital portosystemic shunts in children: therapeutic options and outcomes. J Pediatr Gastroenterol Nutr 2010;51(3):322–330.

Published

2022-01-26

How to Cite

1.
Gonçalves I, Barros D, Araújo M, Machado AI, Oliveira C, Pinto L. Type II Abernethy Malformation: A Rare Cause of Hepatic Encephalopathy in Adulthood . EJCRIM [Internet]. 2022 Jan. 26 [cited 2026 Nov. 3];9(1). Available from: https://ejcrim.com/index.php/ejcrim/article/view/3145

Most read articles by the same author(s)