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Introduction Spina Ventosa is a rare condition that is easy to misdiagnose as other diseases. We present a case of late-diagnosed Spina Ventosa, which had not only the osteoarticular tuberculosis symptoms but also some severe symptoms, including pleural effusion, ascites, and anemia. By intensive treatment, our patient recovered completely. Case report A 7-year-old boy was admitted with complaints of painless swelling of metacarpals, metatarsals, and phalanges of his hands and feet and a discharging sinus of the left toe. There was no family or past history of tuberculosis. His immunizations were up to date. General examination revealed that the child had pallor and was emaciated. No lymphadenopathy was detected. Investigations revealed hemoglobin: 74 g/l, and erythrocyte sedimentation rate (ESR) was 42 mm/hour. QuantiFERON-TB test was positive. The radiograph showed irregular swelling with sclerosis of the underlying bones. The right-hand x-ray showed cortical destruction, sclerosis, and cystic expansion or right second metacarpal. Chest x-ray indicated pleural effusion. Histopathological examination of specimen from the foot and lung and abdomen fluid confirmed tuberculosis. The child was treated with the first-line tuberculosis treatment regimen (Isoniazid, Rifampicin, Ethambutol, and Pyrazinamide) for two months, followed by Isoniazid, Rifampicin, and Pyrazinamide for a further four months. His lesions disappeared after six weeks of intensive treatment. Conclusion A delay in diagnosis and treatment of tuberculosis can lead to systemic manifestations in multiple organs. Despite the delay in diagnosis, this child had a good outcome due to being treated promptly and adequately after the presentation.

Abernethy malformation, also known as Congenital absence of the portal vein (CAPV), is a very rare malformation. There are some reports of liver transplantation as a treatment for CAPV, and our report is the first case in Vietnam. A 10-year-old boy, diagnosed with Abernethy type 1b malformation (portal vein draining directly into the inferior vena cava) and liver tumor. Living donor liver transplantation was performed using a right liver graft from his mother. Histopathological examination of the native liver showed a huge mass lesions within the right liver and absence of portal vein in portal space. Postoperatively, the patient attained optimal liver function and at a 13-month follow-up has returned to normal life. Keywords: Congenital absence of the portal vein, Abernethy malformation, Liver transplantation