Direct left gastroepiploic-renal vein communication: a novel variant of congenital extrahepatic portosystemic shunt.

Congenital portosystemic shunts are rare developmental anomalies that permit portal blood to bypass hepatic filtration. We describe a novel gastrorenal shunt identified during routine cadaveric dissection. A large aberrant vein connecting the left renal vein directly to the left gastroepiploic vein, forming an unusual connection between the systemic and portal circulations. The portal venous system was otherwise intact, with no evidence of hepatic fibrosis or portal hypertension. This configuration does not conform to previously reported portosystemic shunt malformation patterns and is most consistent with a previously unreported variant of a Type II congenital extrahepatic portosystemic shunt.