IS Case 392: Patent umbilical vein

Nate Johnson, MD


2009 URMC Imaging Sciences
Publication Date: 2010-03-09

History

Patient is a 55-year-old man with liver failure seen for pre-transplant evaluation.

Findings

Patent umbilical vein extending from the liver to the umbilicus.

Discussion

In the fetus, oxygenated blood flows from the placenta through the umbilical vein and into fetal circulation. Patency and utility for vascular access remains until about one week after birth. This vein is frequently utilized for vascular access in the neonate when necessary for emergency resuscitation, transfusion or central venous access.

In the adult, the umbilical vein undergoes degeneration and forms the ligamentum teres hepatis which extends from the free edge of the falciform ligament of the liver to the umbilicus. In portal hypertension, collateral pathways begin to form. One of which is by recannulization of the umbilical vein as seen in our patient.

This recannulization parallels the severity of other collaterals (except esophageal varices), but is not sufficient to decompress the increased pressure in the portal system.

References

  1. Young TH, Lee HS. Images in clinical medicine. Recanalized umbilical vein. N Engl J Med. 2007 Oct 18;357(16):e17. PMID: 17942868
  2. Aagaard J, Jensen LI, Sørensen TI, Christensen U, Burcharth F. Recanalized umbilical vein in portal hypertension. AJR Am J Roentgenol. 1982 Dec;139(6):1107-10. PMID: 6983253

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