Giant tortuous umbilical vein in a cirrhotic patient

A 59-year-old male was admitted to our department with abdominal distension, splenomegaly and liver cirrhosis. MRI showed a Segment-6 tumor (Panel A) and a giant dilated vein (Panel A and B). During the laparoscopic hepatectomy, a tortuous umbilical vein was found (Panel C). The patient had no complications or recurrence in an 8-month follow-up. Patent umbilical vein exists in about 7.4% cases of liver cirrhosis, more than 50% of which are accompanied by other collateral shunts such as esophageal, perisplenic or mesenteric veins. It was very unusual that the patient had liver cirrhosis and a giant umbilical vein but no other collateral shunts. We speculate this giant umbilical vein with the diameter of 28.0 mm (3.5 times of the mean value of 7.97 mm) may exert sufficient function to reduce the hepatic inflow pressure to a degree that other portal vein branches can be protected from dilation.

Acknowledgments

The authors thank to Dr. Gang Xu and Dr. Xueshuai Wan for providing technical help to this research.

Funding: This study was funded by CAMS Innovation Fund for Medical Sciences (CIFMS) (No. 2016-I2M-1–001) and the National Natural Science Foundation of China (Grant No. 81972698).

Footnote

Provenance and Peer Review: This article was a standard submission to the Hepatobiliary Surgery and Nutrition. The article did not undergo external peer review.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.org/article/view/10.21037/hbsn-20-636/coif). The authors have no conflicts of interest to declare.

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