Intrahepatic aneurysmal portohepatic venous shunt: what should be done?

Aneurysmal portohepatic venous shunt is communication between the branches of portal and hepatic veins that shows aneurysmal dilatation. They are rare. However with advances in cross-sectional imaging techniques and increased utilization of imaging modalities, the detection of asymptomatic intrahepatic portosystemic venous shunts has increased. Identification and characterization of the portosystemic shunts is very important for radiologists as well as hepatologists. These lesions may be mistaken for hypervascular lesions on CT or cysts on sonography (if colour doppler is not used). Patients with smaller shunts are regularly followed up whereas those with larger or symptomatic shunts (causing hepatic encephalopathy, galactosemia or hyperammonemia) have to be treated.