Aberrant Right and Left Gastric Veins as a Cause of Hepatic Pseudolesions: A Report of Three Cases

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 11; p. e48455
• Main Authors: Quiroz Alfaro, Alejandro J, Herrera Ortiz, Andrés Felipe, Cardona Ortegón, Jose D, Varney, Hannah, Borrero León, Rodrigo, Torres, David F, Greiffenstein, Juliana, Dussan Tovar, Catalina A, Aguirre, Diego A
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 07.11.2023
• Subjects: Abdomen; Asymptomatic; Biopsy; Blood vessels; Epidemiology; Gastric cancer; Health sciences; Hemodynamics; Irritable bowel syndrome; Liver; Medical diagnosis; Medicine; Patients; Physiology; Veins & arteries; cross-sectional imaging; hepatopetal flow; third inflow; aberrant gastric veins; aberrant liver anatomy; gastric cancer spread; embryology; differential diagnoses; digital drawings; hepatic pseudolesions
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.48455

The complex structure of the liver and its elaborate hemodynamics can cause hepatic pseudolesions on contrast-enhanced imaging, making the interpretation of diagnostic liver imaging challenging. Aberrant gastric veins are rare; most of their epidemiology data comes from small single-center studies. While current literature suggests that pseudolesions originating from aberrant gastric veins mainly present as hyperdense defects, some cases can also show up as hypodense, as shown in these cases. Differences in flow rates between the portal and aberrant veins and the timing of the scans could explain this contradiction. Identifying aberrant gastric veins on cross-sectional imaging is crucial because they could be misdiagnosed as liver lesions, granting further unnecessary workups or invasive procedures. Aberrant gastric veins can also act as pathways for the spread of gastric cancer. This manuscript presents one aberrant right gastric vein and two aberrant left gastric veins causing hepatic pseudolesions.