Essential mesocaval shunt is very rare entity. A case of chronic cholecystitis with mesocaval shunt from the branch of superior mesenteric vein was reported. This rare hepatofugal pathway was clearly demonstrated by percutaneous transhepatic portography. Selective middle colic venography showed that the branch of this vein was directly connected to the inferior vena cava. After ligation and resection of the shunt, the level of patient's blood ammonia was decreased and the pressure of portal vein was increased. This rare case indicate that the possibility of early diagnosis and interventional radiology for +hepatic encephalopathy.