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Related Experiment Videos

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
PubMed
Summary

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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.

Related Experiment Videos

  • 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.