[Transjugular portosystemic shunt. An alternative in recurrent hemorrhage in portal hypertension in children].
The transjugular portosystemic bypass is a new technique for treating portal hypertension of an intrahepatic nature by inserting a multipurpose catheter through the jugular vein and vena cava as far as the suprahepatic vein, with the aid of a puncture device it is fed via the hepatic parenchyma into a portal branch. The passageway thus created is distended with a balloon to permit the insertion of an extensible metal mesh prosthesis or "stent" to maintain a permeable connection. Our experiment was conducted on a paediatric patient suffering from mucoviscidosis with severe pulmonary and hepatic involvement and recurrent bleeding in an uncontrollable position. After inserting the bypass, portal pressure dropped sharply and the bleeding stopped, the patient being discharged on the sixth day. Two months after the bypass, the coronary vein of the stomach, the seat of the gastric varicose veins, was selectively occluded through the stent via the femoral vein. Six months after follow-up, the digestive bleeding has not recurred.
Broto
J
J
Departamento de Cirugía Pediátrica, Unidad de Gastroenterología, Ciudad Sanitaria Vall d'Hebron, Barcelona.
Rius
J M
JM
Tormo
R
R
Infante
D
D
Casasa
J M
JM
Gil Vernet
J M
JM
Marhuenda
C
C
Presedo
A
A
Boix Ochoa
J
J
D000293:Adolescent; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control*; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D008297:Male; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D015607:Stents; D013997:Time Factors
La derivación porto sistémica transyugular. Una alternativa ante ciertas hemorragias recidivantes por hipertensión portal en el niño.