Surgical Ligation of Portosystemic Shunt to Resolve Severe Hematuria and Hemafecia Caused by Type II Abernethy Malformation

The purpose of this study was to report the use of venous pressure measurement during surgery for Abernethy malformation (AF). This is a case report of a 19-year-old man who suffered from hematuria and hemafecia for 3 months with worsening symptoms a week before being sent to the emergency room. He was diagnosed with type II AF based on portal phlebography. We performed an open surgery; measured portal vein, inferior mesenteric vein (IMV), and inferior vena cava pressure; and decided to completely suture the IMV. Anticoagulation therapy was used during follow-up, and CTV showed increased portal vein diameter at 12 months after the procedure. For type II AF, measuring extrahepatic portal venous pressure changes before and after shunt blockage during surgery can help determine whether it is feasible to block the shunt, and anticoagulation therapy can improve patient prognosis.