c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Distal Splenorenal (Warren) Shunt: 1

A D V E R T I S E M E N T

   
 

A 57-year-old man with portal hypertension from alcoholic cirrhosis had multiple bleeds from esophageal varices, and multiple endoscopic interventions (sclerosis and banding). The patient was a Child's class A in general medical condition. He was taken to the operating room for a selective, distal splenorenal (Warren) shunt to decompress his varices.      

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Distal Splenorenal (Warren) Shunt: 2

A D V E R T I S E M E N T

   
 

Preoperative angiogram was performed. The celiac injection showed a hepatosplenic trunk with an independent takeoff of the left gastric from the aorta. In addition, a replaced left hepatic artery to segments II and III (see hepatic segmental atlas) was present (see biliary variation). The left hepatic branch to segment IV came off the proper hepatic.     

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Distal Splenorenal (Warren) Shunt: 3

A D V E R T I S E M E N T

   
 

The Superior mesenteric artery was injected to assess the portal system (see portal vein anatomy) in the venous phase.       

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This page was last modified on 6/13/2001.