Der linksseitige Pfortaderastverschluss des Neugeborenen

PURPOSE: The occlusion of the left portal vein in newborn infants is shown and discussed in 14 cases. MATERIALS AND METHODS: The occlusion of the left portal vein in ten male and in four female newborn infants was diagnosed using ultrasound. Only one of the newborn infants was treated with an umbilical vessel catheter. In one case the occlusion of the left portal vein was suspected in an MRI. In the remaining 12 patients, the diagnosis was an incidental finding. RESULTS: Real-time ultrasound showed a hyperechogenic left portal vein without receiving a signal in duplex sonography in thirteen patients. A partly obstructive thrombus was only seen in one patient. Seven patients had enlarged and increased liver arteries already during the primary examination. Recanalization was achieved in two patients who received anticoagulative treatment and in one patient spontaneously. In the other eleven patients the liver arteries increased in caliber and number. DISCUSSION: The origin of the occlusion of the left portal vein is based on the adjustment to the postnatal hemodynamic situation in the umbilical recess. So far there is no evidence of the development of a permanent defect. For this reason and because of the possibility of spontaneous recanalization, treatment with anticoagulative drugs is hardly questioned. CONCLUSION: Occlusion of the left portal vein is mostly an incidental finding. It may appear without catheterizing the umbilical vessel and might be a reason for the "idiopathic lack" of the left portal vein.