Preservation of distal splenorenal shunt in a patient requiring left nephrectomy

We report a case in which a prior distal splenorenal shunt for bleeding esophageal varices was preserved during subsequent left nephrectomy for adenocarcinoma. At nephrectomy portal hypertension with numerous collateral varices to the splenic vein was not a major technical problem. Shunt integrity was documented by postoperative angiography.