Closure of an intrahepatic porto-systemic shunt in a newborn with hypoglycemia, hyperammonemia, and hyperbilirubinemia

Abstract

A newborn with hypoglycemia was transferred to the neonatal intensive care unit. An elevated bilirubin level prompted an abdominal ultrasound, which revealed a large portosystemic shunt. Due to persistent hypoglycemia, hyperammonemia, and hyperbilirubinemia for 3 weeks, the patient was taken to cardiac catheterization, where the portosystemic shunt was closed with an Amplatzer Vascular Plug IV. The patient's metabolic abnormalities abated. He remained asymptomatic 12 months after the procedure.