MANAGEMENT OF STENOSIS OF DISTAL SPLENORENAL SHUNT BY BALLOON DILATION

  • 1 January 1983
    • journal article
    • research article
    • Vol. 157  (1) , 43-48
Abstract
Stenosis of a distal splenorenal shunt may lead to inadequate variceal decompression with the risk of rebleeding. This complication was reported in 3 patients at 5, 16 and 17 mo. after DSRS, with successful management by balloon dilation. One patient had rebled from varices and the other 2 showed roentgenologic evidence of inadequate variceal decompression. All of the shunts were patent, but showed a mean pressure gradient of 15 mm Hg which was reduced to a mean of 7 mm Hg by dilation. Angiography at 15 mo. showed no restenosis and sustained reduction of the pressure gradient in 1 patient. The other 2 patients await long term follow-up observation. Rebleeding or reappearance of varices are indications for repeat angiography after DSRS to determine the cause. The risk of dilating a venous anastomosis must be weighed against the risk of rebleeding; the results of this report demonstrate that this can be done with a satisfactory outcome.