Compartmentalized gastrosplenic and mesenteric venous hypertension after distal splenorenal shunt occlusion: response to mesocaval shunt and splenectomy.
This is a report of a patient with a thrombosed Warren shunt and recurrent variceal hemorrhage who demonstrated compartmentalized venous hypertension in the mesenteric and gastrosplenic systems. Although the mesenteric presssure was normalized by the construction of a mesocaval interposition shunt, the gastrosplenic venous pressure remained elevated until splenectomy was performed. Warren shunt occlusion should be considered as a cause of segmental portal hypertension. Splenectomy may be a necessary adjunct in patients suitable for reshunting.
D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D003097:Collateral Circulation; D004932:Esophageal and Gastric Varices / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology*; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery; D011168:Portal System / Q000033:anatomy & histology; D012077:Renal Artery / Q000601:surgery*; D013156:Splenectomy; D013162:Splenic Vein / Q000601:surgery*; D013927:Thrombosis / Q000209:etiology; D014684:Venae Cavae / Q000601:surgery