title: Distal inferior mesenteric veins to renal vein shunt for treatment of bleeding anorectal varices: case report and review of literature.
abstract: Isolated intractable bleeding from anorectal varices is a rare complication of portal hypertension. We report a case of a patient with cirrhosis and hepatofugal flow who had severe lower gastrointestinal bleeding from anorectal varices. This is the first case report of construction of a distal inferior mesenteric vein shunt to left renal vein as a selective shunt for treatment of bleeding anorectal varices in a patient with hepatofugal flow. The patient is a 39-year-old white man with a medical history significant for alcohol abuse who was seen with bright red blood per rectum requiring 10 units of packed red blood cells over the course of a year. The work-up revealed anorectal varices with no other colonic lesions. The patient underwent construction of a distal inferior mesenteric vein to left renal vein shunt.
authors.affiliation: Connecticut Vascular Institute, Hartford Hospital, 85 Seymour Street, Hartford, CT 06102, USA.
authors.forename: Omid
authors.initials: O
authors.lastname: Rahmani
authors.forename: Lorraine M
authors.initials: LM
authors.lastname: Wolpert
authors.forename: A David
authors.initials: AD
authors.lastname: Drezner
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D006471:Gastrointestinal Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012007:Rectum / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D014648:Varicose Veins / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*