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Related Experiment Videos

Mesocaval shunt: patency after 22 years--a case report.

H Abu-Judeh1, P Bahramipour, K G Swan

  • 1Department of Radiology, UMDNJ/NJMS, 185 South Orange Avenue, Newark, NJ 07103, USA.

Vascular Surgery
|October 5, 2001
PubMed
Summary

A mesocaval shunt effectively controlled esophageal variceal bleeding in a cirrhosis patient for 23 years. The shunt remained patent, with the patient alive and well, experiencing minimal complications.

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Area of Science:

  • Hepatology
  • Vascular Surgery
  • Gastroenterology

Background:

  • Portal hypertension secondary to Laennec's cirrhosis can cause life-threatening esophageal varices.
  • Urgent intervention is sometimes required to manage severe gastrointestinal hemorrhage from these varices.

Observation:

  • A 52-year-old man with Laennec's cirrhosis and alcoholism underwent urgent mesocaval shunt placement for esophageal variceal hemorrhage.
  • The patient had no history of alcoholic hepatitis.

Findings:

  • The mesocaval shunt remained angiographically patent 23 years post-procedure.
  • The patient was alive and well with no hepatic encephalopathy, except for three episodes of gastrointestinal hemorrhage due to peptic ulcer disease.
  • Hepatic coma episodes resolved promptly with conservative management (cathartics, enemas, lactulose) after bleeding cessation.

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Implications:

  • Mesocaval shunts can provide long-term patency and survival for patients with portal hypertension and esophageal varices.
  • This case highlights the potential for durable outcomes with surgical management of variceal bleeding.
  • Effective management of secondary complications like peptic ulcer disease is crucial for long-term patient well-being.