Asymptomatic congenital splenorenal shunt in a noncirrhotic patient with a left adrenal aldosterone-producing adenoma.
Portosystemic shunts frequently develop in patients with cirrhosis. However, congenital splenorenal shunts are rare anomalies in people without portal hypertension. Here, we present a case of a venous shunt between the spleen and left renal vein in a 57-year-old man with no history of liver cirrhosis, portal hypertension, or hepatic encephalopathy. The abnormal vessel was identified on preoperative contrast-enhanced computed tomography performed for diagnosis of a left adrenal aldosterone-producing adenoma. The shunt was safely ligated during transperitoneal laparoscopic left adrenalectomy. Excessive bleeding due to accidental injury of the shunting vessel during the procedure is a likely complication. Careful review of preoperative computed tomography images and cautious management of this type of shunt, especially in cirrhotic patients, can prevent this serious complication.
Lin
Yi-Ting
YT
Department of Urology, China Medical University Hospital, Taichung, Taiwan.
Chang
Chao-Hsiang
CH
Chen
Wen-Chi
WC
D000236:Adenoma / Q000000981:diagnostic imaging / Q000378:metabolism*; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism*; D000450:Aldosterone / Q000096:biosynthesis*; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000098:blood supply*; D014057:Tomography, X-Ray Computed
D000450:Aldosterone