Case report Focal sparing of fatty liver in segment II associated with aberrant left gastric vein

We present a patient with aberrant left gastric vein (LGV) that directly enters the posterior edge of segment II in the liver. The corresponding area was focally spared of fatty liver. We consider that this aberrant LGV contributed to the cause of focal sparing. This is the first report of the use of helical CT and Doppler ultrasound to depict the aberrant LGV that directly enters the liver. Non-portal venous flow draining into the liver such as the parabiliary venous system (1), and epigastric and cholecystic veins, cause pseudolesions in various locations of the liver on CT during arterial portography (CTAP) (2). The aberrant right gastric vein, which is included in the parabiliary venous system, causes focal sparing of fatty liver as well as a pseudolesion at the posterior edge of segment IV in the liver (3). The aberrant left gastric vein (LGV), which runs along the hepatogastric ligament and enters the liver (4), also causes pseudolesions in segments II and IV of the liver on CTAP (5). We present a patient with focal sparing of fatty liver in segment II caused by the aberrant LGV that directly enters the liver. The aberrant LGV was visualized on helical CT, and hepatopetal flow was confirmed by colour Doppler ultrasound (US).