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Splenoadrenal shunt. An original portosystemic decompressive technique
E Jovine1, M Cescon, G Ercolani
1Divisione di Chirurgia Generale, Dipartimento Discipline Chirurgiche Rianimatorie e dei Trapianti, University of Bologna, Policlinico S. Orsola Via Massarenti, 9, 40138 Bologna, Italy. ejovine@unibo.it
Hepato-Gastroenterology
|March 28, 2001
Summary
A splenoadrenal shunt using the left adrenal vein is an effective surgical option for patients with difficult-to-treat esophageal and gastric varices caused by portal hypertension. This procedure offers a viable alternative when other treatments fail.
Area of Science:
- Hepatology
- Surgical Gastroenterology
- Vascular Surgery
Background:
- Gastrointestinal hemorrhage from esophageal and gastric varices due to portal hypertension is a significant clinical challenge.
- Surgical portosystemic shunts are indicated for sclerotherapy-resistant varices in patients with preserved hepatic function.
Observation:
- A 63-year-old male with idiopathic liver fibrosis, portal hypertension, and variceal bleeding underwent a planned distal splenorenal shunt.
- During surgery, a large left adrenal vein was identified and utilized for an end-to-end anastomosis with the distal splenic vein, creating a splenoadrenal shunt.
Findings:
- The splenoadrenal shunt procedure was uneventful.
- Postoperative ultrasound and splenic angiography confirmed shunt patency and efficacy.
- The patient was discharged on postoperative day 15.
Implications:
- Splenoadrenal shunt using the left adrenal vein is a feasible and effective surgical alternative for managing refractory esophagogastric varices.
- This technique provides a valuable option for selected patients with portal hypertension and preserved liver function.