splenocaval shunt as you can

splenocaval shunt as you can see the blue tortuous vessel curve and enter dorsally into the cvc. See attached images. Nice views.. this is the most common shunt  (about 65% of ehpss). As you can see splenocavals are short shunts 1-2 cm long so easily missed in the portal hilus and hidden often by ascending and transverse colonic artifact but you did a nice job getting around that here. My theory of the old concept of  “you can’t see shunts on ultrasound ” is because the splenocaval shunts are short small shunts and the majority of the ehpss out there, this is the major reason why shunts were shunned by sonographers for so long because its ta tough maneuver on historically non standard to image this reason readily every time but is essential in our circles for this reason and in modern circles if taught thoroughly… lots of occult pathology in the portal hilus (CBD, panc, hepatic nodes, pylorus gb/cystic duct…) and of course can’t do a shunt hunt without going here even if the patient doesnt want you here… passive gradual manual pressure is essential to work with the patient tension as you did here or sedatetion will help.

But once you know the technique then the imaging is pretty easy and then the interpretation comes after.

Nice job and the surgeon should be prepared for an ameroid for around 0.5-0. cm wide here.

Here are some more splenoaval shunts and others from the archive:

http://sonopath.com/members/case-studies/search?text=splenocaval+shunt&species=All