Left sided segmental portal hypertension following mesocaval interposition shunt

C. L. Witte, T. W. Ovitt, Marlys H Witte, D. S. Clark

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Following a mesocaval interposition shunt in three patients with cirrhosis of the liver, bleeding esophageal varices recurred in two and left sided portal hypertension partially persisted in one patient. Angiographic and pressure studies of the portal system demonstrated effective decompression of the greater splanchnic venous system but continued lesser splanchnic venous hypertension. Recurrent variceal hemorrhage ceased following splenectomy done as an emergency. In contrast to a standard portacaval shunt, it is suggested that after an interposition mesocaval shunt, altered jet streaming of mesenteric blood flow may divert gastrosplenic venous drainage away from the interposition shunt with persistence of lesser splanchnic venous hypertension. Recognition of this entity and of the need for splenectomy is advocated.

Original languageEnglish (US)
Pages (from-to)169-174
Number of pages6
JournalSurgery Gynecology and Obstetrics
Volume145
Issue number2
StatePublished - 1977

Fingerprint

Viscera
Portal Hypertension
Splenectomy
Hemorrhage
Surgical Portacaval Shunt
Hypertension
Portal System
Esophageal and Gastric Varices
Decompression
Liver Cirrhosis
Drainage
Emergencies
Pressure

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Surgery

Cite this

Left sided segmental portal hypertension following mesocaval interposition shunt. / Witte, C. L.; Ovitt, T. W.; Witte, Marlys H; Clark, D. S.

In: Surgery Gynecology and Obstetrics, Vol. 145, No. 2, 1977, p. 169-174.

Research output: Contribution to journalArticle

Witte, C. L. ; Ovitt, T. W. ; Witte, Marlys H ; Clark, D. S. / Left sided segmental portal hypertension following mesocaval interposition shunt. In: Surgery Gynecology and Obstetrics. 1977 ; Vol. 145, No. 2. pp. 169-174.
@article{6bb7451693524907a86575f0a2968b90,
title = "Left sided segmental portal hypertension following mesocaval interposition shunt",
abstract = "Following a mesocaval interposition shunt in three patients with cirrhosis of the liver, bleeding esophageal varices recurred in two and left sided portal hypertension partially persisted in one patient. Angiographic and pressure studies of the portal system demonstrated effective decompression of the greater splanchnic venous system but continued lesser splanchnic venous hypertension. Recurrent variceal hemorrhage ceased following splenectomy done as an emergency. In contrast to a standard portacaval shunt, it is suggested that after an interposition mesocaval shunt, altered jet streaming of mesenteric blood flow may divert gastrosplenic venous drainage away from the interposition shunt with persistence of lesser splanchnic venous hypertension. Recognition of this entity and of the need for splenectomy is advocated.",
author = "Witte, {C. L.} and Ovitt, {T. W.} and Witte, {Marlys H} and Clark, {D. S.}",
year = "1977",
language = "English (US)",
volume = "145",
pages = "169--174",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Left sided segmental portal hypertension following mesocaval interposition shunt

AU - Witte, C. L.

AU - Ovitt, T. W.

AU - Witte, Marlys H

AU - Clark, D. S.

PY - 1977

Y1 - 1977

N2 - Following a mesocaval interposition shunt in three patients with cirrhosis of the liver, bleeding esophageal varices recurred in two and left sided portal hypertension partially persisted in one patient. Angiographic and pressure studies of the portal system demonstrated effective decompression of the greater splanchnic venous system but continued lesser splanchnic venous hypertension. Recurrent variceal hemorrhage ceased following splenectomy done as an emergency. In contrast to a standard portacaval shunt, it is suggested that after an interposition mesocaval shunt, altered jet streaming of mesenteric blood flow may divert gastrosplenic venous drainage away from the interposition shunt with persistence of lesser splanchnic venous hypertension. Recognition of this entity and of the need for splenectomy is advocated.

AB - Following a mesocaval interposition shunt in three patients with cirrhosis of the liver, bleeding esophageal varices recurred in two and left sided portal hypertension partially persisted in one patient. Angiographic and pressure studies of the portal system demonstrated effective decompression of the greater splanchnic venous system but continued lesser splanchnic venous hypertension. Recurrent variceal hemorrhage ceased following splenectomy done as an emergency. In contrast to a standard portacaval shunt, it is suggested that after an interposition mesocaval shunt, altered jet streaming of mesenteric blood flow may divert gastrosplenic venous drainage away from the interposition shunt with persistence of lesser splanchnic venous hypertension. Recognition of this entity and of the need for splenectomy is advocated.

UR - http://www.scopus.com/inward/record.url?scp=0017752042&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0017752042&partnerID=8YFLogxK

M3 - Article

VL - 145

SP - 169

EP - 174

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 2

ER -