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Management of stenosis of distal splenorenal shunt by balloon dilation.
Surg Gynecol Obstet. 1983 Jul; 157(1):43-8.SG

Abstract

Stenosis of a distal splenorenal shunt may lead to inadequate variceal decompression with the risk of rebleeding. We report this complication in three patients at five, 16 and 17 months after DSRS, with successful management by balloon dilation. One patient had rebled from varices and the other two showed roentgenologic evidence of inadequate variceal decompression. All of the shunts were patent but showed a mean pressure gradient of 15 millimeters of mercury which was reduced to a mean of 7 millimeters of mercury by dilation. Angiography at 15 months showed no restenosis and sustained reduction of the pressure gradient in one patient. The other two patients await long term follow-up observation. Rebleeding or reappearance of varices are indications for repeat angiography after DSRS to determine the cause. The risk of dilating a venous anastomosis must be weighed against the risk of rebleeding; the results of this report demonstrate that this can be done with a satisfactory outcome.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

6602389

Citation

Henderson, J M., et al. "Management of Stenosis of Distal Splenorenal Shunt By Balloon Dilation." Surgery, Gynecology & Obstetrics, vol. 157, no. 1, 1983, pp. 43-8.
Henderson JM, El Khishen MA, Millikan WJ, et al. Management of stenosis of distal splenorenal shunt by balloon dilation. Surg Gynecol Obstet. 1983;157(1):43-8.
Henderson, J. M., El Khishen, M. A., Millikan, W. J., Sones, P. J., & Warren, W. D. (1983). Management of stenosis of distal splenorenal shunt by balloon dilation. Surgery, Gynecology & Obstetrics, 157(1), 43-8.
Henderson JM, et al. Management of Stenosis of Distal Splenorenal Shunt By Balloon Dilation. Surg Gynecol Obstet. 1983;157(1):43-8. PubMed PMID: 6602389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of stenosis of distal splenorenal shunt by balloon dilation. AU - Henderson,J M, AU - El Khishen,M A, AU - Millikan,W J,Jr AU - Sones,P J, AU - Warren,W D, PY - 1983/7/1/pubmed PY - 2001/3/28/medline PY - 1983/7/1/entrez SP - 43 EP - 8 JF - Surgery, gynecology & obstetrics JO - Surg Gynecol Obstet VL - 157 IS - 1 N2 - Stenosis of a distal splenorenal shunt may lead to inadequate variceal decompression with the risk of rebleeding. We report this complication in three patients at five, 16 and 17 months after DSRS, with successful management by balloon dilation. One patient had rebled from varices and the other two showed roentgenologic evidence of inadequate variceal decompression. All of the shunts were patent but showed a mean pressure gradient of 15 millimeters of mercury which was reduced to a mean of 7 millimeters of mercury by dilation. Angiography at 15 months showed no restenosis and sustained reduction of the pressure gradient in one patient. The other two patients await long term follow-up observation. Rebleeding or reappearance of varices are indications for repeat angiography after DSRS to determine the cause. The risk of dilating a venous anastomosis must be weighed against the risk of rebleeding; the results of this report demonstrate that this can be done with a satisfactory outcome. SN - 0039-6087 UR - https://www.unboundmedicine.com/medline/citation/6602389/Management_of_stenosis_of_distal_splenorenal_shunt_by_balloon_dilation_ DB - PRIME DP - Unbound Medicine ER -