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Standard or Variant Meso-Rex Shunts for Children with Variceal Bleeding due to Extrahepatic Portal Vein Obstruction: A Report of Two Cases

Vascular Specialist International 2020년 36권 3호 p.186 ~ 192
오문영, Kim Hyo-Kee, 한아람, 이남준, 민승기,
소속 상세정보
오문영 ( Oh Moon-Young ) - Seoul National University Hospital Department of Surgery
 ( Kim Hyo-Kee ) - Seoul National University College of Medicine Department of Surgery
한아람 ( Han Ah-Ram ) - Seoul National University College of Medicine Department of Surgery
이남준 ( Yi Nam-Joon ) - Seoul National University College of Medicine Department of Surgery
민승기 ( Min Seung-Kee ) - Seoul National University College of Medicine Department of Surgery

Abstract


Extrahepatic portal vein obstruction (EHPVO) is the most common cause of pediatric portal hypertension and can cause life-threatening variceal bleeding. Meso- Rex shunt (MRS) is a surgical procedure that restores physiological portal venous blood flow to the liver by using a graft to connect the superior mesenteric vein and the left portal vein within the Rex recess, and can relieve variceal bleeding and other complications associated with EHPVO. Although the MRS is regarded as an optimal and potentially curative treatment with good long-term patency, graft thrombosis or failure due to unknown causes is not rare, prompting the need for further research on the risk factors of graft failure or poor patency. Herein, we report two cases of EHPVO in patients with recurrent or uncontrolled variceal bleeding, one treated with the classic Rex shunt and the other with the modified Rex shunt, which resulted in a failure and success, respectively.

키워드

Mesenteric venous thrombosis; Vascular grafting; Portal hypertension; Esophageal and gastric varices; Meso-Rex shunt

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