Kinking of a Warren shunt as a cause of recurrent variceal hemorrhage.
Upper gastrointestinal hemorrhage after portal decompression requires appropriate endoscopic and radiologic evaluation for unrelated causes. Splenoportography may be more definitive than selective visceral angiography and in the present case showed a patent but kinked venovenous anastomosis with a high splenic pulp pressure. A mesocaval interposition shunt controlled the hemorrhage. Various technical factors responsible for anastomotic narrowing and kinking of the Warren shunt are briefly mentioned.
D001807:Blood Vessel Prosthesis; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008642:Mesenteric Veins / Q000601:surgery; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011169:Portal Vein / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000601:surgery*; D011859:Radiography; D012008:Recurrence; D012082:Renal Veins / Q000601:surgery; D013162:Splenic Vein / Q000000981:diagnostic imaging / Q000601:surgery; D014682:Vena Cava, Inferior / Q000601:surgery
D011093:Polyethylene Terephthalates