Distal splenorenal shunt (DSS) in children: analysis of the first 21 consecutive cases.

Abstract:

:Twenty-one children from the ages of 4 to 12 years old were treated for esophageal hemorrhage by distal splenorenal shunt (DSS). In four patients, thrombosis of the shunt occurred within the first 24 hours after operation. In the other 17 children, long-term shunt patency was verified. Only one thrombosis has occurred in the last 15 consecutive cases. The patients were followed from one-half to six years. Late angiographic studies were performed in five patients. Forward flow through the portal vein was demonstrated in all patients. In addition, collateralization between the portomesenteric (PM) and gastrosplenic (GS) compartments was present in each case. In four patients with a wide-open shunt, the direction of collateral flow was from the PM to the GS compartment. In one child in whom the shunt was partially obstructed, the flow was from the GS to the PM compartment. In all 17 successful cases, esophageal variceal hemorrhage ceased, and there were no instances of hepatic encephalopathy. It is concluded that DSS is a safe and effective surgical procedure for the treatment of esophageal bleeding in children.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Maksoud JG,Mies S

doi

10.1097/00000658-198204000-00004

subject

Has Abstract

pub_date

1982-04-01 00:00:00

pages

401-5

issue

4

eissn

0003-4932

issn

1528-1140

journal_volume

195

pub_type

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