Simplifying the Shunt Hunt: A Practical Ultrasound Approach

Simplify the shunt hunt by applying the structured SDEP® Abdominal Scanning Protocol, focusing on SDEP® Positions 9–14 to systematically evaluate hepatic vasculature. Lecture attendees will review normal hepatic vascular anatomy before exploring practical strategies for identifying both extrahepatic (EHPSS) and intrahepatic portosystemic shunts (IHPSS). The session emphasizes the concept of the negative shunt hunt (using consistent scanning maneuvers to rule out shunts when they are not present while avoiding common sonographic pitfalls). Clinical integration is also highlighted, including recognition of compatible clinical signs, interpretation of laboratory findings, congenital considerations, and the role of advanced imaging such as CT. Real-world diagnostic obstacles and current approaches to medical and surgical management will be discussed to help clinicians approach suspected shunts with greater confidence and efficiency.

• Identify key hepatic vascular anatomy and apply SDEP scanning positions 9–14 to systematically evaluate the portal system.
• Differentiate extrahepatic and intrahepatic portosystemic shunts using sonographic patterns and schematics.
• Apply the concept of the negative shunt hunt to confidently rule out shunts and recognize common imaging pitfalls.