PMID: 6978110Apr 1, 1982Paper

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

Annals of Surgery
J G Maksoud, S Mies

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.

References

Jun 1, 1978·Journal of Pediatric Surgery·J G MaksoudV C Pinto
Sep 1, 1978·Annals of Surgery·L F RikkersW D Warren
Feb 1, 1979·Journal of Pediatric Surgery·B M Rodgers, J L Talbert
Nov 1, 1979·American Journal of Surgery·P M GekasG W Smith
Nov 11, 1976·The New England Journal of Medicine·J T GalambosA A Salam
Sep 1, 1980·Annals of Surgery·W D WarrenB A Faraj
Jan 1, 1954·The Journal of Clinical Investigation·W V McDERMOTT, R D ADAMS

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Citations

Apr 1, 1985·World Journal of Surgery·J ValayerJ Broto
Apr 1, 1986·American Journal of Surgery·J G MaksoudL C da Costa Gayotto
Feb 1, 1991·Journal of Pediatric Surgery·J G MaksoudM C Velhote
Mar 1, 1994·Journal of Pediatric Surgery·T H RenardR N McClelland
Oct 1, 1988·The British Journal of Surgery·W D Warren, J M Henderson
Mar 1, 1984·The British Journal of Surgery·M J Cooper, R C Williamson
Oct 1, 1984·The British Journal of Surgery·J M HendersonW D Warren
Mar 1, 1994·World Journal of Surgery·J G Maksoud, M E Gonçalves
Oct 1, 1982·Journal of Pediatric Surgery·J R LillyG Stellin

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