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HPB Surgery
Volume 10 (1998), Issue 6, Pages 365-370
http://dx.doi.org/10.1155/1998/39129

Portal Decompression Using the Inferior Mesenteric Vein

1Departments of Surgery, Ospedale Borselli, Ferrara, Italy
2University of Washington School of Medicine, Seattle, USA

Received 1 August 1996; Accepted 10 February 1997

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report five patients with variceal hemorrhage, in three cases secondary to diffuse thrombosis of the portal, superior mesenteric and splenic veins. Mesenteric angiography demonstrated patency of the inferior mesenteric vein (IMV) in each, and successful portal decompression by anastomosis of the IMV to the left renal vein (n=4) or the inferior vena cava (n=1) was accomplished. Bleeding was permanently controlled: four patients have survived from one to eight years post-operatively. Because shunt procedures utilizing the IMV are technically straightforward, subtotally decompress the portal system and avoid the right upper quadrant, they may be advantageous in certain clinical settings.