Tender lumps in the inguinal region are often explored emergently to treat suspected hernial strangulation. We discuss the case of an adult male who presented acutely with a tender inguinal swelling and raised inflammatory markers and was therefore deemed as requiring surgical exploration. However preoperative abdominal computerized tomography (CT) revealed an extensive thrombosing congenital venous malformation of portosystemic origin with extension into the symptomatic inguinal canal. A potentially lethal exsanguination from surgery was thus avoided.
Shinkai M., Ohhama Y., Nishi T., et al. Congenital absence of the portal vein and role of liver transplantation in children. J Pediatr Surg. 2001;36(7):1026-1031.
6.
Nii A., Takehara HO, Kuyama H., Shimada M.Successful preemptive surgical division of type 2-congenital extrahepatic portosystemic shunt in children. J Med Invest. 2009;56(1-2):49-54.
7.
Yamagami T., Yoshimatsu R., Matsumoto T., et al. Successful embolization using interlocking detachable coils for a congenital extrahepatic portosystemic venous shunt in a child. J Pediatr Surg. 2007;42(11):1949-1952.
8.
Hu GH, Shen LG, Yang J., Mei JH, Zhu YFInsight into congenital absence of the portal vein: is it rare? World J Gastroenterol. 2008; 14(39):5969-5979.