Mesoatrial shunting for portal decompression in alcoholic cirrhosis.
A 36-year-old Chinese man with alcoholic cirrhosis presented to hospital with exsanguinating variceal hemorrhage. Conventional porta-systemic decompressive operations could not be done because of dense vascular adhesions from two previous operations and a sub-hepatic abcess. A mesenteric-to-right-atrial shunt was done with successful control of hemorrhage and reduction of portal pressure. Long-term follow-up reveals no further bleeding and a return to full-time employment. We conclude that mesoatrial shunting is a useful alternative procedure for portasystemic decompression in alcoholic cirrhosis, although one which will be needed only in unusual circumstances.
D000328:Adult; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006325:Heart Atria / Q000601:surgery; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000601:surgery*; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery; D011170:Portasystemic Shunt, Surgical / Q000379:methods*