Interposition mesocaval H shunt associated with a left inferior vena cava

Area of Science:

• Vascular anatomy
• Surgical interventions
• Gastroenterology

Background:

• Anatomical variations of the inferior vena cava (IVC) are clinically significant, particularly during abdominal surgical procedures.
• Esophageal varices often necessitate surgical intervention to manage recurrent bleeding, with shunting procedures being a common approach.

Observation:

• During diagnostic angiography for recurrent esophageal varices, a patient presented with an unusual anatomical variation: a single left inferior vena cava.
• This congenital anomaly of the inferior vena cava was identified prior to surgical planning.

Findings:

• A mesocaval H shunt was successfully performed in the patient despite the presence of the single left inferior vena cava.
• This surgical outcome demonstrates the feasibility of mesocaval shunting in the context of this rare IVC anomaly.

Implications:

• This case highlights the importance of preoperative anatomical assessment, especially for rare variations like a single left IVC.
• The successful mesocaval H shunt in this unique scenario expands the surgical options for managing portal hypertension and esophageal varices.
• Further investigation into managing complex vascular anomalies during shunting procedures is warranted.