Splenorenal arterial bypass in a child with Takayasu's disease: a case report

In adults splenorenal arterial bypass is a highly effective treatment for renovascular hypertension, but in children the procedure has been less successful because of the small size of the splenic artery. However, with the improvement in microvascular techniques the procedure is now possible in children. A 2-year-old child with Takayasu's arteritis, previous right nephrectomy and severe renovascular hypertension required revascularization to salvage his remaining left kidney. A splenorenal arterial bypass was performed through a left retroperitoneal flank incision. Postoperatively his creatinine level returned to normal and his requirements for antihypertensive medication were markedly diminished. The advantages of a splenorenal arterial bypass for left renal revascularization in a developing child are discussed.