Spontaneous Thrombosis of Congenital Extrahepatic Portosystemic Shunt (Abernethy Malformation) Simulating Inguinal Hernia Incarceration

Tender lumps in the inguinal region are often explored emergently to treat suspected hernial strangulation. We discuss the case of an adult male who presented acutely with a tender inguinal swelling and raised inflammatory markers and was therefore deemed as requiring surgical exploration. However p...

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Bibliographic Details
Published in:Vascular and endovascular surgery 2010-08, Vol.44 (6), p.508-510
Main Authors: Afzal, Samara, Nair, Amit, Grainger, Jennie, Latif, Sherif, Rehman, Atiq-ur
Format: Article
Language:English
Subjects:
Adult
Anticoagulants - therapeutic use
Azygos Vein - abnormalities
Biological and medical sciences
Diagnosis, Differential
Hernia, Inguinal - diagnosis
Humans
Liver, biliary tract, pancreas, portal circulation, spleen
Magnetic Resonance Angiography
Male
Medical sciences
Phlebography
Portal Vein - abnormalities
Portal Vein - diagnostic imaging
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Tomography, X-Ray Computed
Treatment Outcome
Vascular Malformations - complications
Vascular Malformations - diagnosis
Vascular Malformations - diagnostic imaging
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
Vena Cava, Inferior - abnormalities
Vena Cava, Inferior - diagnostic imaging
Venous Thrombosis - diagnostic imaging
Venous Thrombosis - drug therapy
Venous Thrombosis - etiology
Warfarin - therapeutic use
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Summary:Tender lumps in the inguinal region are often explored emergently to treat suspected hernial strangulation. We discuss the case of an adult male who presented acutely with a tender inguinal swelling and raised inflammatory markers and was therefore deemed as requiring surgical exploration. However preoperative abdominal computerized tomography (CT) revealed an extensive thrombosing congenital venous malformation of portosystemic origin with extension into the symptomatic inguinal canal. A potentially lethal exsanguination from surgery was thus avoided.
ISSN:1538-5744
1938-9116
DOI:10.1177/1538574410373666