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[Hemodynamic study of the patient with hemorrhagic portal hypertension: importance of the left renal vein in patients with a distal splenorenal shunt (Warren)].
Rev Gastroenterol Mex. 2006 Jul-Sep; 71(3):257-61.RG

Abstract

INTRODUCTION

There is no information in the literature about surgical outcome of the distal splenorenal shunt (Warren shunt) in those patients with anomalous flow in the left renal vein to the inferior vena cava.

OBJECTIVE

The purpose of this manuscript was to evaluate the incidence of thrombosis in the Warren shunt in those patients with anomalous flow in the left renal vein to the inferior vena cava.

METHODS

We performed a prospective, descriptive and longitudinal study in those patients who performed a surgical procedure to the treatment of hemorrhagic portal hypertension in a tertiary referral center in Mexico City during a one year period (2002-2003). Before the surgical procedure an arterial and venous angiographic study was done including celiac axis, superior mesenteric artery and splenic artery. The patients were scheduled in the outpatient office the first, third, sixth month and the year after the surgical procedure. We looked in them for gastrointestinal bleeding secondary to portal hypertension. In those patients with Warren shunt an angiographic study was done during the first month after the surgical procedure.

RESULTS

Twenty eight patients were included, 17 of them women (60.7%). Median patient age was 48 years old. In 20 patients a Warren shunt were done and in eigth patients a devascularization operation were done. The anomalous flow of the left renal vein was identified in nine patients (28.7%). In seven of them a Warren shunt were done and in two of them a devascularization operation were done. We didn't find gastrointestinal bleeding or thrombosis of the Warren shunt in any of these patients.

CONCLUSION

In those cases of patients with anomalous flow in the left renal vein a Warren shunt can be performed. In this study we didn't find thrombosis of the shunt or gastrointestinal bleeding. In this way a surgical decompression of the portal system can be done preventing bleeding episodes.

Authors+Show Affiliations

Clinica de Hipertensión Portal y Departamento de Radiologia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. orozco@quetzal.innsz.mxNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

spa

PubMed ID

17140046

Citation

Orozco, Héctor, et al. "[Hemodynamic Study of the Patient With Hemorrhagic Portal Hypertension: Importance of the Left Renal Vein in Patients With a Distal Splenorenal Shunt (Warren)]." Revista De Gastroenterologia De Mexico, vol. 71, no. 3, 2006, pp. 257-61.
Orozco H, Tielve M, Ramos G, et al. [Hemodynamic study of the patient with hemorrhagic portal hypertension: importance of the left renal vein in patients with a distal splenorenal shunt (Warren)]. Rev Gastroenterol Mex. 2006;71(3):257-61.
Orozco, H., Tielve, M., Ramos, G., & Mercado, M. A. (2006). [Hemodynamic study of the patient with hemorrhagic portal hypertension: importance of the left renal vein in patients with a distal splenorenal shunt (Warren)]. Revista De Gastroenterologia De Mexico, 71(3), 257-61.
Orozco H, et al. [Hemodynamic Study of the Patient With Hemorrhagic Portal Hypertension: Importance of the Left Renal Vein in Patients With a Distal Splenorenal Shunt (Warren)]. Rev Gastroenterol Mex. 2006 Jul-Sep;71(3):257-61. PubMed PMID: 17140046.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Hemodynamic study of the patient with hemorrhagic portal hypertension: importance of the left renal vein in patients with a distal splenorenal shunt (Warren)]. AU - Orozco,Héctor, AU - Tielve,Manuel, AU - Ramos,Guillermo, AU - Mercado,Miguel Angel, PY - 2006/12/5/pubmed PY - 2007/3/21/medline PY - 2006/12/5/entrez SP - 257 EP - 61 JF - Revista de gastroenterologia de Mexico JO - Rev Gastroenterol Mex VL - 71 IS - 3 N2 - INTRODUCTION: There is no information in the literature about surgical outcome of the distal splenorenal shunt (Warren shunt) in those patients with anomalous flow in the left renal vein to the inferior vena cava. OBJECTIVE: The purpose of this manuscript was to evaluate the incidence of thrombosis in the Warren shunt in those patients with anomalous flow in the left renal vein to the inferior vena cava. METHODS: We performed a prospective, descriptive and longitudinal study in those patients who performed a surgical procedure to the treatment of hemorrhagic portal hypertension in a tertiary referral center in Mexico City during a one year period (2002-2003). Before the surgical procedure an arterial and venous angiographic study was done including celiac axis, superior mesenteric artery and splenic artery. The patients were scheduled in the outpatient office the first, third, sixth month and the year after the surgical procedure. We looked in them for gastrointestinal bleeding secondary to portal hypertension. In those patients with Warren shunt an angiographic study was done during the first month after the surgical procedure. RESULTS: Twenty eight patients were included, 17 of them women (60.7%). Median patient age was 48 years old. In 20 patients a Warren shunt were done and in eigth patients a devascularization operation were done. The anomalous flow of the left renal vein was identified in nine patients (28.7%). In seven of them a Warren shunt were done and in two of them a devascularization operation were done. We didn't find gastrointestinal bleeding or thrombosis of the Warren shunt in any of these patients. CONCLUSION: In those cases of patients with anomalous flow in the left renal vein a Warren shunt can be performed. In this study we didn't find thrombosis of the shunt or gastrointestinal bleeding. In this way a surgical decompression of the portal system can be done preventing bleeding episodes. SN - 0375-0906 UR - https://www.unboundmedicine.com/medline/citation/17140046/[Hemodynamic_study_of_the_patient_with_hemorrhagic_portal_hypertension:_importance_of_the_left_renal_vein_in_patients_with_a_distal_splenorenal_shunt__Warren_]_ L2 - http://www.diseaseinfosearch.org/result/5881 DB - PRIME DP - Unbound Medicine ER -