Abstract
A case of secondary portal hypertension due to extrahepatic portal vein ob struction that was treated by splenopneumopexy approximately nine years ago is presented. The patient was a forty-seven-year-old man suffering from hema temesis. On preoperative portography, the portal trunk could not be visualized, and cavernous transformation of the portal vein and moderate esophageal varices were demonstrated.
Splenopneumopexy for management of esophageal varices was accomplished as treatment. After the operation, significant portopulmonary shunt was devel oped and findings of the esophageal varices were improved. Results from pul monary and hepatic function tests after operation were essentially unchanged. For nine years since the operation he has had no episode of recurrent variceal bleeding.
Splenopneumopexy, which diverts the portal blood into the pulmonary vein, is one of the shunt procedures used as treatment for portal hypertension. In Japan, endoscopic sclerotherapy is the first choice of treatment for variceal bleeding. However, splenopneumopexy is still useful as a treatment for patients with secondary portal hypertension such as extrahepatic portal vein obstruc tion.
Get full access to this article
View all access options for this article.