Mesocaval shunt for portal hypertensive small bowel bleeding documented with intraoperative enteroscopy.
BACKGROUND
Besides upper gastrointestinal tract, small bowel has also been implicated as a potential source of hemorrhage in patients with portal hypertension.


METHODS
We report an interesting case of recurrent massive small intestinal bleeding in a patient with portal hypertension secondary to liver cirrhosis treated with a mesocaval shunt. Endoscopic assessment with gastroscopy and colonoscopy failed to identify the source of hemorrhage. An intraoperative enteroscopy was conducted which revealed a diffuse bleeding pattern from the small bowel mucosa.


CONCLUSIONS
An interposition mesocaval shunt procedure was successfully carried out on an emergency basis that eventually managed to control bleeding.


CONCLUSIONS
In cases, where a diffuse pattern of hemorrhage exist or non-operative measures fail emergency mesocaval shunting seems to be an efficacious alternative treatment approach for portal hypertension related intestinal bleeding.
General Surgery Department, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece.
Dimitrios
D
Symeonidis
Georgios
G
Koukoulis
Grigorios
G
Christodoulidis
Ioannis
I
Mamaloudis
Ioannis
I
Chatzinikolaou
Konstantinos
K
Tepetes