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Portal decompression using the inferior mesenteric vein

P Gorini¹, K Johansen

¹Departments of Surgery, Ospedale Borselli, Ferrara, Italy.

HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery

|March 27, 1998

Summary

This summary is machine-generated.

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This study shows that surgically connecting the inferior mesenteric vein (IMV) to the renal vein or vena cava effectively treated variceal hemorrhage caused by portal vein thrombosis. Four out of five patients experienced long-term survival and bleeding control.

Area of Science:

Vascular Surgery
Gastroenterology
Interventional Radiology

Background:

Variceal hemorrhage is a serious complication of portal vein thrombosis.
Traditional treatments may have limitations or risks.

Observation:

Five patients with variceal hemorrhage secondary to portal, superior mesenteric, and splenic vein thrombosis were studied.
Mesenteric angiography confirmed inferior mesenteric vein (IMV) patency in all cases.

Findings:

Successful portal decompression was achieved by creating an anastomosis between the IMV and the left renal vein (4 patients) or the inferior vena cava (1 patient).
All patients experienced permanent control of bleeding.
Four patients survived for one to eight years post-operatively.

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Implications:

Shunt procedures using the IMV are technically straightforward and offer substantial portal decompression.
These procedures avoid the right upper quadrant, potentially reducing operative risks.
IMV shunts represent an advantageous surgical option for specific clinical scenarios involving portal hypertension and thrombosis.