Severe hemolysis after distal splenorenal shunt

We report a case of severe hemolysis after distal splenorenal shunt. Hemolysis was suddenly recognized at the time splenorenal venous anastomosis was completed, and it continued on the operative day and the first postoperative day. After the shunt, the intraoperative splenic venous blood flow was approximately double its previous level, as measured by electromagnetic flowmeter. Angiographic partial splenic embolization was performed on the second postoperative day, and then hemolysis stopped suddenly. This suggested that hemolysis after distal splenorenal shunt was related to increased splenic blood flow and acceleration of erythrocyte destruction.