Percutaneous recanalization of a thrombosed Meso-Rex shunt

Abstract

Extra-hepatic portal vein obstruction can cause severe portal hypertension. Meso-rex shunting is a surgical option to bypass the extrahepatic portal venous obstruction, connecting the superior mesenteric vein to the left portal vein, restoring hepato-petal blood flow. This is an alternative to porto-systemic shunts (e.g. spleno-renal shunt)in a setting of normal liver function and intrahepatic vasculature. Our case is of a 3yo patient who underwent meso-rex shunt creation, which was complicated by thrombosis and recurrent varices and ascites. Percutaneous recanalization and stenting via a trans-splenic approach was successful, and the shunt remained patent at follow up at 1,3, and 5 months.

Keywords

• Meso-Rex shunt
• Portal vein occlusion
• Portal hypertension