Title: Proximal Splenorenal Shunt (PSRS) for Management of Upper Gastrointestinal Bleeding due to Extra Hepatic Portal Vein Obstruction (EHPVO)
Authors: Sarat Chandra Jayasingh, Chitta Ranjan Sarangi, Mihir K Mohapatra
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.201
Abstract
Background: Extrahepatic portal vein obstruction (EHPVO) is a common cause of variceal bleeding in a children and young adult in India. Management with endoscopic means provide temporary palliation. Proximal splenorenal shunt (PSRS) is definitive & provides long term control of variceal bleed.
Methods: Between January 2011 & October 2017 we performed 20 elective proximal splenorenal shunts for EHPVO
Results: Postoperative mortality was zero, rebleeding occurred in 2 cases, pneumococcal infection & encephalopathy was never detected in any patient & no patient died during follow up.
Conclusion: Proximal splenorenal shunt for bleeding varices due to EHPVO is a definitive procedure with very low mortality, morbidity, and better long term result.
Keywords: Extrahepatic portal vein obstruction(EHPVO), proximal splenorenal shunt (PSRS).
References
- K Sarin, J. D. Sollano, Y.K Chawla et al., “ Consensus on extra-hepatic portal vein obstruction,” Liver international, Vol.26, no. 5, pp. 512-519, 2006.
- K Arora and M.K. Das, Extra Hepatic Portal Venous Obstruction in Children, The INCLEN Trust International, New Delhi, India.
- D Stringer and E.R Howard, “Long term outcome after injection sclerotherapy for esophageal varices in children with extrahepatic portal hypertension,” Gut, vol. 35, no. 2, PP. 257-259, 1994.
- S Prasad, S. Gupta, V. Kohli, G.K Pande, P. Sahni, and S. Nundy, “Proximal splenorenal shunts for extrahepatic portal venous obstruction in children,” Annals of Surgery, vol. 219, no 2, PP. 193-196, 1994.
- K Sharma, H.K Rangam, and R.P Choubey, “ Splenectomy and lieno-renal shunt for extrahepatic portal venous Obstruction,” Indian Pediatrics, vol. 37, no. 4, PP. 422 – 425, 2000.
- Srivastava, S.K Yadav, R. Lal et al., “Effect of surgical portosystemic shunt on prevalence of minimal hepatic encephalopathy in children with extrahepatic portal venous obstruction: assessment by magnetic resonance imaging and psychometry,” Journal of Pediatric Gastroenterology and Nutrition, vol. 51. No. 6, PP. 766-772, 2010.