case_images: PMC3420761_01
case_images: Finger clubbing.
case_images: CRIM.VASMED2011-508171.001.jpg
case_images: PMC3420761_01_CRIM.VASMED2011-508171.001.jpg
case_images: fig1
case_images: Physical examination on admission revealed cyanosis and finger clubbing (Figure 1).
case_images: Pulmonary computed tomographic angiography (CTA) shows pulmonary arteriovenous malformation.
case_images: CRIM.VASMED2011-508171.002.jpg
case_images: PMC3420761_01_CRIM.VASMED2011-508171.002.jpg
case_images: fig2
case_images: Then, pulmonary computed tomographic angiography (CTA) shows pulmonary arteriovenous malformation, perhaps diffuse pulmonary arteriovenous fistulae (Figure 2).
case_images: Contrast echocardiography shows that microbubbles (the arrow) produced by contrast agent enter the left ventricle three heart beats after the right.
case_images: CRIM.VASMED2011-508171.003.jpg
case_images: PMC3420761_01_CRIM.VASMED2011-508171.003.jpg
case_images: fig3
case_images: Contrast echocardiography then showed enhancement in the left heart three beats after microbubbles opacified the right heart, which confirmed intra-pulmonary shunting (Figure 3).
case_images: CTA reveals that intestinal and splenic venous blood bypassed the liver and drains into the inferior vena cava.
case_images: CRIM.VASMED2011-508171.004.jpg
case_images: PMC3420761_01_CRIM.VASMED2011-508171.004.jpg
case_images: fig4
case_images: The CTA revealed that intestinal and splenic venous blood bypasses the liver and drains into the inferior vena cava (Figure 4).