Left sided segmental portal hypertension following mesocaval interposition shunt

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

Research output: Contribution to journalArticle

10 Scopus citations

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 - Dec 1 1977

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ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology

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