A high incidence of spontaneous splenorenal shunting shown by digital splenoportography

Abstract

The technique of digital splenoportography with thin flexible needles and small amounts of dilute contrast medium is described as one particularly suitable for use in paediatric patients. The authors report a high incidence of spontaneous splenorenal shunting revealed in their patients by this technique.

A Large Spontaneous Splenorenal Shunt in a Patient with Liver Cirrhosis and Uncomplicated Portal Hypertension

“…unexplained why many patients with large portosystemic shunts have encephalopathy [16,24,26,27] or bleeding varices [9,10,22,23], whereas others (such as our patient) do not suffer from these complications [10,20]. For bleeding, the age of the patient is probably important, children with spontaneous splenorenal shunt being at very high risk of gastroesophageal bleeding [14]. No correlation was reported between the risk of bleeding and the type of shunt [10].…”

“…A high incidence of spontaneous splenorenal shunting was reported in pediatric patients [14,15]. A Discussion congenital splenorenal shunting was described in a 68-year-old woman with recurrent episodes of portal sysIn this study, we describe an unusual large spontaneous splenorenal shunt and recanalization of the umbilical vein temic encephalopathy [16].…”

“…amounts of contrast medium appears the more suitable method [14]. In conclusion, cirrhotic and noncirrhotic portal hypertension with splenomegaly and hypersplenism and with…”

“…[56][57][58]. Transhepatic portography in patients with Specific treatments (portocaval shunt or splenectomy) several complications, as reported in the literature [10,14,24,27]. These patients should be carefully evaluated are necessary when spontaneous splenogastrorenal shunts are associated with massive, recurrent, life-with the various available diagnostic techniques, simpler and noninvasive, such as duplex Doppler ultrasonothreatening gastric variceal bleeding or hepatic encephalopathy and precoma [22,24,27].…”

Effect of Spontaneous Portosystemic Shunts on Hemorrhage from Esophagogastric Varices

“…They are usually of large diameter and drain a significant amount of splanchnic blood into the systemic circulation, bypassing the esophagogastric veins [1, 2]. The clinical importance of the shunts remains of great interest, as there is a discrepancy regarding the protective effect of MSPSSs from esophagogastric variceal (EGV) bleeding and the development of hepatic encephalopathy in cirrhotic patients [1, 2, 3, 4, 5, 6, 7, 8]. Many cirrhotic patients continue to maintain an elevated portal pressure and suffer from variceal hemorrhage even in the presence of an MSPSS.…”