LEFT SIDED SEGMENTAL PORTAL-HYPERTENSION FOLLOWING MESOCAVAL INTERPOSITION SHUNT

  • 1 January 1977
    • journal article
    • research article
    • Vol. 145  (2) , 169-174
Abstract
Following a mesocaval interposition shunt in 3 patients with cirrhosis of the liver, bleeding esophageal varices recurred in 2 and left sided portal hypertension partially persisted in 1 patient. Angiographic and pressure studies of the portal system demonstrated effective decompression of the greater splanchnic venous system but continued lesser splanchnic venous hypertension. Recurrent variceal hemorrhage ceased following splenectomy done as an emergency. In contrast to a standard portacaval shunt it is suggested that after an interposition mesocaval shunt altered jet streaming of mesenteric blood flow may divert gastrosplenic venous drainage away from the interposition shunt with persistence of lesser splanchnic venous hypertension. Recognition of this entity and of the need for splenectomy is advocated.

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