Percutaneous revascularization of reoccluded meso-Rex shunts in extrahepatic portal vein obstruction.

J Pediatr Surg

Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.

Published: September 2012

AI Article Synopsis

  • Extrahepatic portal vein obstruction (EHPVO) is a rare condition in young children that causes prehepatic portal hypertension due to blocked blood flow in the portal vein.
  • The preferred treatment is a meso-Rex shunt, which reconnects the blood flow from the superior mesenteric vein to the left portal vein using a vein graft.
  • In this study, two patients with partial blockage of their meso-Rex shunt were successfully treated using non-surgical procedures, with their progress monitored over time.

Article Abstract

Extrahepatic portal vein (PV) obstruction (EHPVO) is a rare disorder in early childhood with unknown incidence and mostly unknown etiology. In children with EHPVO, the hepatopedal flow of the mesenteric venous blood is hindered by an obstruction of the PV resulting in prehepatic portal hypertension. The curative treatment with a meso-Rex shunt connects the superior mesenteric vein to the left PV by a venous autograft. Despite good primary patency, reocclusion of a meso-Rex bypass and its treatment can be challenging. We present 2 patients with EHPVO with subtotal functional occlusion of a meso-Rex shunt treated by percutaneous interventions with short- and mid-term follow-up.

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http://dx.doi.org/10.1016/j.jpedsurg.2012.04.011DOI Listing

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