case_images: PMC5023639_01
case_images: White arrow right portal branch, black arrow inferior vena cava, gray arrow hepatic shunt
case_images: 40064_2016_3221_Fig1_HTML.jpg
case_images: PMC5023639_01_40064_2016_3221_Fig1_HTML.jpg
case_images: Fig1
case_images: This herniation led to torsion of the caval axis and occlusion of the right and middle hepatic veins with modification of liver outflow, thus creating a right to left hepatic vein shunt passing anteriorly to the umbilical recess (Fig. 1).
case_images: White arrow hepatic shunt, black arrow diaphragm, gray arrow round ligament
case_images: 40064_2016_3221_Fig2_HTML.jpg
case_images: PMC5023639_01_40064_2016_3221_Fig2_HTML.jpg
case_images: Fig2
case_images: Exclusively the left lobe remained inside the abdominal cavity with traction of the hepatic hilum under the right diaphragm with the round and falciform ligament overlying the diaphragm sustaining the liver (Fig. 2).
case_images: White arrow ligament compressing the inferior vena cava, black arrow inferior vena cava above the liver
case_images: 40064_2016_3221_Fig3_HTML.jpg
case_images: PMC5023639_01_40064_2016_3221_Fig3_HTML.jpg
case_images: Fig3
case_images: The liver was rotated in the abdominal cavity intraoperatively: this retraction revealed a ligament between the diaphragm and the liver determining compression of the inferior vena cava (Fig. 3).
case_images: White arrow hepatic veins and shunt in front of the round ligament blue arrow portal system
case_images: 40064_2016_3221_Fig4_HTML.jpg
case_images: PMC5023639_01_40064_2016_3221_Fig4_HTML.jpg
case_images: Fig4
case_images: A shift of the liver outflow was seen with a natural by-pass inverting flow from the right and middle hepatic veins to a large accessory hepatic vein in the parenchymal bridge in front of the umbilical recess and then to the left hepatic vein (Fig. 4).