Abstract
Abernathy malformations are congenital extrahepatic porto-systemic shunts which allow splanchnic circulation to bypass the metabolic screen of the liver and drain directly into the systemic circulation. The resulting metabolic abnormalities have a multitude of implications ranging from hyperammonaemia, hepatic encephalopathy, to pulmonary hypoxemia. The shunt also causes anatomical implications in the form of varices. Interventional radiology plays the central role in this era of minimal invasive surgeries from establishing diagnosis to therapeutic interventional management. The holistic approach provided through interventional radiology reduces intraprocedural time as well as hospital stay. We describe a very rare case of peripheral congenital porto-systemic shunt communicating Inferior mesenteric vein and internal iliac vein with rectal bleed with complete management at the department of interventional radiology.