Successful management of a congenital portosystemic shunt using coil-in-plug embolization: A case report

A 20-year-old man was referred to pediatrics for hyperbilirubinemia and mental retardation. Abdominal ultrasonography findings were indicative of a portosystemic shunt, and as a shunt between the left branch of the portal vein and inferior vena cava was confirmed by abdominal computed tomography, he was diagnosed with patency of the venous duct. We decided to perform shunt embolization using IVR, but as the shunt diame-ter had expanded like a funnel, its embolization was performed using a plug-and -metal coil, which led to an im-provement in hepatic reserve and blood ammonia levels postprocedure. Surgical ligation has been typically used in the management of portosystemic shunts, but as it is highly invasive, shunt embolization by IVR has become prevalent in recent years. Here we describe stable embolization using the IVR technique.