Porto-systemic shunt using adrenal vein as a conduit; an alternative procedure for spleno--renal shunt.
BACKGROUND
Currently, portal hypertension is still big problem for the patients with serious liver diseases. Variceal bleeding is one of the most important complications of portal hypertension. In case of failure of endoscopic and combined medical treatments, surgical decompressive shunts are required. We emphasized an alternative splenorenal shunt procedure using adrenal vein as a conduit.


METHODS
A 26-year-old male suffered from recurrent variceal bleeding was considered for surgical therapy. Although we planned to perform a distal splenorenal shunt procedure, it was observed to be difficult. Therefore left adrenal vein was used as a conduit between left renal vein and splenic vein after splenic artery was ligated. He did well and was discharged from the hospital on the postoperative day 6. In the follow up period for nine months, endoscopic and ultrasonographic examinations were normal.


CONCLUSIONS
We concluded that, in case of failure to perform distal splenorenal shunt due to technical problems, alternative porto-systemic shunt procedure using the adrenal vein as a vascular conduit can be safely employed.
Aydin
Unal
U
Ege University School of Medicine, Department of Surgery, Izmir, Turkey. drunalaydin@yahoo.com
Yazici
Pinar
P
Kilic
Murat
M
D000311:Adrenal Glands / Q000098:blood supply*; D000328:Adult; D000714:Anastomosis, Surgical; D019160:Endosonography; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004945:Esophagoscopy; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000175:diagnosis*; D007813:Laparotomy / Q000379:methods; D008297:Male; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D013164:Splenorenal Shunt, Surgical; D016896:Treatment Outcome; D014680:Veins / Q000601:surgery