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Indian J Pediatr. 2013 Dec;80(12):1053-5. doi: 10.1007/s12098-013-0972-4. Epub 2013 Feb 7.

Congenital portosystemic venous shunt in a preterm Rh-isoimmunized infant.

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Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, Newborn Health Knowledge Centre, WHO Collaborating Centre for Training and Research in Neonatal Care, ICMR Centre for Advanced Research in Newborn Health, New Delhi, India.


The authors report a preterm infant with Rh-isoimmunization, who had persistent hepato-splenomegaly with conjugated hyperbilirubinemia, transaminitis, and hyperammonemia. Ultrasound abdomen revealed an intrahepatic portosystemic venous shunt (PSVS). The child was managed conservatively. On follow up at 2.4 y of age, the child is having normal growth and development, but with persisting shunt. Severe Rh-isoimmunisation in a neonate can sometimes share some of the features of congenital PSVS and delay the diagnosis of the latter. The index case had shunt ratio >80 % during the neonatal period but did not require any intervention.

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