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Peer-reviewedCC BY-NC-ND 4.0BMC Gastroenterology

Right portal vein-inferior vena cava shunt in portal hypertension: a multicenter case series of a rare spontaneous portosystemic shunt

  • Bin Xiong1,2
  • Tongqiang Li3
  • Kun Ji1,2
  • Chongtu Yang4
  • Qin Shi5
  • Hongan Tian6
  • Xiaoli Zhu7
  • Chen Zhou8,9,10
10 affiliations
  1. 1Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, Zhejiang Province 310000 China
  2. 2Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province China
  3. 3Department of Interventional Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province China
  4. 4Department of Radiology, West China Hospital, Chengdu, Sichuan Province China
  5. 5Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
  6. 6Department of Radiology, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei Province China
  7. 7Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, Jiangsu Province China
  8. 8Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province China
  9. 9Hubei Provincial Clinical Research Center for Precision Radiology & Interventional Medicine, Wuhan, Hubei Province China
  10. 10Hubei Key Laboratory of Molecular Imaging, Wuhan, Hubei Province China
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Abstract

Objectives: Spontaneous portosystemic shunts (SPSS) caused by portal hypertension often require to be treated when associated with clinical symptoms in patients. This study aims to report a rare type of spontaneous portosystemic shunt: the Right Portal Vein-Inferior Vena Cava Shunt (RPIVS).

Methods: This retrospective observational study collected the cirrhosis patients with RPIVS according to the electronic medical record systems between January 2017 to September 2024 from seven medical centers in China. Demographic information, imaging characteristics, laboratory data, treatment, and outcomes were collected.

Results: A total of the data of 2165 cirrhosis patients were reviewed and 25 (1.15%) patients (mean age 56.2 ± 11.7 years; 80.0% male) presented RPIVS, with hepatitis B cirrhosis as the dominant etiology (72.0%). Among these patients, 14 (56.0%, 14/25) were hospitalized due to gastrointestinal bleeding, 10 (40.0%, 10/25) were due to the detection of liver tumor, and 1 (4.0%, 1/25) presented with impaired liver function. Three patients developed hepatic encephalopathy, and 3 patients experienced rebleeding. Among the 14 patients admitted for gastrointestinal bleeding, 5 received conservative treatment alone, 6 received endoscopic treatment combined with conservative treatment and/or splenectomy, and 3 underwent TIPS. Among the 10 patients admitted for liver tumor, 7 received liver tumor-related treatment, 1 underwent liver transplantation, 1 received HAIC combined with PTCD and biliary stent implantation, and 1 was awaiting liver transplantation.

Conclusion: This study confirms the existence of RPIVS as a rare shunt and speculates on its anatomical basis, which is of great significance for further understanding of portal hypertension and achieving more precise interventions.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12876-026-05198-2.

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Cite

BibTeXRIS
BibTeX
@article{xiong2026right,
  title = {{Right portal vein-inferior vena cava shunt in portal hypertension: a multicenter case series of a rare spontaneous portosystemic shunt}},
  author = {Bin Xiong and Tongqiang Li and Kun Ji and Chongtu Yang and Qin Shi and Hongan Tian and Xiaoli Zhu and Chen Zhou},
  journal = {BMC Gastroenterology},
  year = {2026},
  month = aug,
  doi = {10.1186/s12876-026-05198-2},
  url = {https://doi.org/10.1186/s12876-026-05198-2},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Right portal vein-inferior vena cava shunt in portal hypertension: a multicenter case series of a rare spontaneous portosystemic shunt
AU  - Bin Xiong
AU  - Tongqiang Li
AU  - Kun Ji
AU  - Chongtu Yang
AU  - Qin Shi
AU  - Hongan Tian
AU  - Xiaoli Zhu
AU  - Chen Zhou
PY  - 2026
DA  - 2026/08/08
JO  - BMC Gastroenterology
DO  - 10.1186/s12876-026-05198-2
UR  - https://doi.org/10.1186/s12876-026-05198-2
AB  - Objectives: Spontaneous portosystemic shunts (SPSS) caused by portal hypertension often require to be treated when associated with clinical symptoms in patients. This study aims to report a rare type of spontaneous portosystemic shunt: the Right Portal Vein-Inferior Vena Cava Shunt (RPIVS).  Methods: This retrospective observational study collected the cirrhosis patients with RPIVS according to the electronic medical record systems between January 2017 to September 2024 from seven medical centers in China. Demographic information, imaging characteristics, laboratory data, treatment, and outcomes were collected.  Results: A total of the data of 2165 cirrhosis patients were reviewed and 25 (1.15%) patients (mean age 56.2 ± 11.7 years; 80.0% male) presented RPIVS, with hepatitis B cirrhosis as the dominant etiology (72.0%). Among these patients, 14 (56.0%, 14/25) were hospitalized due to gastrointestinal bleeding, 10 (40.0%, 10/25) were due to the detection of liver tumor, and 1 (4.0%, 1/25) presented with impaired liver function. Three patients developed hepatic encephalopathy, and 3 patients experienced rebleeding. Among the 14 patients admitted for gastrointestinal bleeding, 5 received conservative treatment alone, 6 received endoscopic treatment combined with conservative treatment and/or splenectomy, and 3 underwent TIPS. Among the 10 patients admitted for liver tumor, 7 received liver tumor-related treatment, 1 underwent liver transplantation, 1 received HAIC combined with PTCD and biliary stent implantation, and 1 was awaiting liver transplantation.  Conclusion: This study confirms the existence of RPIVS as a rare shunt and speculates on its anatomical basis, which is of great significance for further understanding of portal hypertension and achieving more precise interventions.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12876-026-05198-2.
SN  - 1471-230X
ER  -