A Case with the Unusual Portal-right Renal Vein Collateralin Extra-Hepatic Pre-Sinusoidal Portal Hypertention

A case with the unusual portal-right renal vein collateral in extra-hepatic presinusoidal portal hypertention was reported. The patient was a 50-year-old female, who was admitted with the complaints of finger termor and gait disturbance. She showed splenomegaly, pancytopenia and hyperammonemia. No esophageal varices were found. The portal collateral between the superior mesentric and right renal vein was revealed by cdiac angiography and right renal venography in retrograde fashion. Splenectomy was done because of hypersplenism. After the operation, the peripheral blood cell findings returned to normal. It was conceived that the hepatic encephalopathy of this case was resulted from the enormous retroperitoneal collateral. Hyperammonemia was improved by administration of Lactulose and the neurological disorders were also gradually recovered. The development of the extremely rare portal collateral between the superior mesentric and right renal vein was considered to be congenital.