NeoNotes
Journal Club
Andrew B. Kairalla MD, Editor
Thomas M. Berger MD, Guest Editor
8-041 | Additional Comments | Previous
Article | Next Article | Search
| List of Articles | Submit
Comments | Index | FSN Home Page | Subscribe
Now
Recanalized Umbilical Vein
Young T-H and Lee H-S. New Engl J Med 357:e17. PDF
A 72-year-old woman with a 10-year history of compensated cirrhosis due to hepatitis C infection presented with swelling of the lower leg. Physical examination showed splenomegaly, spider angiomata, and visible tortuous vessels on the abdominal wall. Axial magnetic resonance imaging through the liver (Panel A) showed a connection (arrow) between the umbilical vein (UV) and the left portal vein (LPV), as well as esophageal varices (arrowhead). Coronal T2-weighted imaging (Panel B) showed a recanalized umbilical vein (arrow) coursing in the anterior abdominal wall to the umbilicus. Normally, after interruption of the placental circulation at birth, the umbilical vein collapses and forms the ligamentum teres in the adult; however, with the development of portal hypertension, the umbilical vein may recanalize and serve as a collateral route.
Comment. I think the oldest patient that I have been able to
successfully pass an umbilical venous catheter (UVC) was 10 days old. Imagine
being able to place a UVC in a 72 year old adult! ABK.
Additional Comments:
Date: 06 Dec 2007
Time: 12:26:17
The recanalization of the umbilical vein is a possible complication of liver cirrhosis, in Germany known as Cruveilhier-von-Baumgarten-syndrome. As a medical student I learned about it from my teacher in internal medicine, a hepatologist, who was also one of the pioneers in ultrasound in medicine in Germany. Kind regards
UserName: Thomas Strahleck
Institution: Olgahospital Stuttgart
telephone:
email: t.strahleck@arcor.de
You may add your own comments to the discussion of this topic by selecting : Submit Comments.