A large spontaneous splenorenal shunt in a patient with liver cirrhosis and uncomplicated portal hypertension

The aim of this paper is to describe and discuss, on the basis of a thoroug h review of the literature, the case of a 70-year-old woman with probable c irrhosis secondary to chronic hepatitis B and C, uncomplicated portal hyper tension (without ascites, encephalopathy or bleeding varices), splenomegaly and hypersplenism, and an unusual, spontaneous, large splenorenal shunt an d recanalization of the umbilical vein. The tortuous and varicose splenoren al shunt was diagnosed by abdominal ultrasound and CT investigations. A dup lex Doppler ultrasonography evaluation was performed to study shunt flow di rection and velocity. No gastroesophageal varices were identified on endosc opic examination. The clinical relevance of spontaneous splenorenal shunt, often associated with fundic gastric varices, is discussed. Copyright (C) 2 000 S. Karger AG. Basel.