Abstract
A portosystemic shunt remaining after a living-donor liver transplantation sometimes causes a postoperative portal venous flow drop. It is diagnosed with Doppler ultrasound, angiography, contrast-enhanced computed tomography or magnetic resonance angiography. We report a case in which a contrast-enhanced ultrasound was useful to find out a portosystemic shunt. The patient is an 8-year-old girl who had undergone a portoenterostomy for biliary atresia and a living-donor liver transplantation for a hepatopulmonary syndrome at that age of 8 years. Because of an ABO incompatible transplant, a catheter was inserted into the portal vein for local infusion therapy. At first, a Doppler ultrasound showed a normal portal venous flow. On the next day of removal of the portal venous catheter, however, her portal venous flow was not able to be confirmed. We supposed a portal thrombosis, but we were unable to confirm it by the contrast-enhanced CT scan. After a contrast-enhanced ultrasound was performed, we could confirm the portal venous flow and the steal of the portal blood through the remaining portosystemic shunt. In conclusion, a contrast-enhanced ultrasound is useful for the blood flow evaluation after a living-donor liver transplantation.
