An ultra-short case report: Middle Hepatic Vein (MHV) stenosis

Sathya Narayana

Consultant- Interventional Radiologist, Kauvery Hospital, Alwarpet, Chennai

Case Presentation

A 11-year-old patient underwent liver transplant, 24 hrs later, the liver enzymes were very high and surveillance USG showed no flow in MHV.

Immediately CECT was done which showed congestion in right lobe.

There was a tight stenosis at the anastomotic site of MHV and IVC.

Management

Initially attempts were made to cannulate the ostium of MHV through right internal jugular vein access but was unable to do it, probably the angulation and tight stenosis prevented it.

Then a percutaneous puncture of the MHV was done and a 6fr sheath was placed

The stenosis was negotiated with wire, then balloon plastied and a 10 mm metal stent was placed across the stenosis.

Conclusion

  • Patient improved clinically well
  • Liver enzymes settled
  • Follow up CT showed good flow in the stent.

Video

Post procedure veno shows good flow from hepatic vein to RA across the stent.

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