Spontaneous splenorenal shunt in a patient with liver cirrhosis and hypertrophic caudal lobe.
Spontaneous splenorenal shunt is a rare condition, sometimes causing complications in cirrhotic patients. We report a 30-year old man with liver cirrhosis, hypertrophic caudal lobe and spontaneous splenorenal shunt. Real-time and color Doppler ultrasonography evidenced enlarged caudal lobe (130 x 95 mm) with direct veins draining into dilated inferior cava vein (diameter 25 mm, flow 52 cm/sec). In the left renal hilus a large vein with a flow typical for portal vein system was found, velocity 25-37 cm/sec. Indirect splenoportography noticed splenomegaly, dilated lienal and portal vein with hepatopetal blood flow, perisplenic varices, and large spontaneous splenorenal shunt. Whole inferior caval vein was dilated, while hepatic veins were intact. Hemodynamic consequences of this large shunt were dilation of inferior cava vein with hyperkinetic systemic flow, and secondary hypertrophy of liver caudal lobe.
Culafic
Dorde
D
Institute of Digestive Diseases, Clinical Centre of Serbia, Mirijevski venac br. 49, Beograd 11160, Serbia and Montenegro. dculafic@EUnet.yu
Perisic
Mirjana
M
Vojinovic-Culafic
Violeta
V
Sagic
Dragan
D
Kerkez
Mirko
M
D000328:Adult; D001159:Arterio-Arterial Fistula / Q000209:etiology*; D006529:Hepatomegaly / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D012082:Renal Veins / Q000473:pathology*; D013162:Splenic Vein / Q000473:pathology*