Case Report: A Rare Syncope Case Caused by Abernethy II and a Review of the Literature

Xue-qin Lin, Jing-yi Rao, Yi-fei Xiang, Li-wei Zhang, Xiao-ling Cai, Yan-song Guo, Kai-yang Lin
Shengli Clinical Medical College of Fujian Medical University and Fujian Provincial Hospital. Fujian Clinical Medical Research Center for Cardiovascular Diseases.
China

Frontiers in Cardiovascular Disease
Front Cardiovasc Dis 2022; 8:
DOI: 10.3389/fcvm.2021.784739

Abstract
Background: Abernethy malformation is an extremely rare anomaly of the splanchnic venous system, and only 2 cases that manifested as syncope had been reported previously. 
Case Presentation: A 24-year-old male had a 15-year history of jaundice and was in long-term use of hepatoprotective drugs. He was admitted for complaint of syncope. He underwent a series of examinations and cardiac ultrasound showed that his pulmonary artery pressure was elevated. Further imaging revealed the absence of intrahepatic portal veins. His blood ammonia was significantly increased. All signs and symptoms pointed to an Abernethy diagnosis. He was finally diagnosed as having Abernethy type II. He was discharged after 17 days of in-hospital treatment with sildenafil (50 mg/day) and ornithine aspartate (20 g/day). 
Conclusion: We now report this rare case of syncope that is caused by Abernethy malformation. As a typically pediatric disease, it was not identified in this patient until adulthood due to long-term treatment for jaundice and liver cirrhosis. Furthermore, we present a review of portosystemic shunts previously reported in the literature.

Category
Class I. Pulmonary Hypertension Associated with Liver Disease
Class I. Pulmonary Hypertension Associated with Cardiovascular Heart Disease
Symptoms and Findings Associated with Pulmonary Vascular Disease

Age Focus: Pediatric Pulmonary Vascular Disease or Adult Pulmonary Vascular Disease

Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication

Article Access Free
PDF File or Full Text Article Available Through PubMed or DOI: Yes

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