title: Subtotal splenectomy and central splenorenal shunt for treatment of bleeding from Roux en Y jejunal loop varices secondary to portal hypertension.
abstract: OBJECTIVE
  To present subtotal splenectomy and splenorenal shunt as a surgical option to treat severe bleeding from a Roux en Y jejunal loop varices secondary to portal hypertension.
  
  
  METHODS
  A 64-year-old white woman presented severe episodes of bleeding from varices inside a Roux en Y jejunal loop secondary to portal hypertension due to cirrhosis. Subtotal splenectomy was performed with preservation of the upper splenic pole supplied by the splenogastric vessels. This procedure was combined with a central splenorenal shunt to divert part of portal blood to systemic flow.
  
  
  RESULTS
  This procedure was safely performed with no complications. A 2-year post-operative follow-up of the patient has been uneventful. No re-bleeding occurred during this period and she returned to her normal life.
  
  
  CONCLUSIONS
  Subtotal splenectomy combined with central splenorenal shunt seems to be a safe procedure useful for the treatment of enteral bleedings due to portal hypertension.
authors.affiliation: Department of Surgery, Medical School of the Federal University of Minas Gerais, Avenida Afonso Pena, 1626-apto. 1901, Belo Horizonte, Minas Gerais, 30130-005, Brazil.
authors.forename: João Baptista
authors.initials: JB
authors.lastname: Rezende-Neto
authors.forename: Andy
authors.initials: A
authors.lastname: Petroianu
authors.forename: Sandra Kelly
authors.initials: SK
authors.lastname: Santana
mesh_terms: D000713:Anastomosis, Roux-en-Y; D002768:Choledochostomy / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D007579:Jejunal Diseases / Q000209:etiology / Q000601:surgery*; D008103:Liver Cirrhosis / Q000150:complications; D008875:Middle Aged; D012008:Recurrence; D013156:Splenectomy / Q000379:methods; D013164:Splenorenal Shunt, Surgical; D013536:Suture Techniques