Evaluation of Rex Shunt on Cavernous Transformation of the Portal Vein in Children

Abstract

Rex shunt is an effective approach for the treatment of children suffering from CTPV at an early stage that do not show additional liver lesions.

Effects of Rex-bypass shunt on the cavernous transformation of the portal vein in children: evaluation by the color Doppler ultrasonography

“…Rex shunt is an effective treatment for CTPV at an early stage in children. The surgery may reduce the portal pressure and the degree of esophagogastric varices, leading to the significant improvement of hypersplenism [3][4][5]. For patients with CTPV, the degree of esophagogastric varices is directly related to the upper gastrointestinal bleeding.…”

“…At present, surgical treatment of CTPV is relatively difficult because the vessels have irregular courses and are susceptible to bleeding [2]. As compared to the traditional treatments (portosystemic shunt, paraesophagogastric devascularization, variceal banding ligation, splenorenal shunt, and sclerotherapy), Rex-bypass shunt is a relatively new and effective surgical intervention for the CTPV without additional liver lesions [3]. It is currently considered as a gold-standard strategy by some surgeons [4,5].…”

Cavernous Transformation of Portal Vein in the Setting of Protein C and Anti-thrombin III Deficiency

“…There is a wide range of spectrum with which the patient presents. Gastroesophageal bleeding secondary to varices and hematological abnormalities in the form of thrombocytopenia and anemia occur because of the development of collateral channels around the portal vein [12]. Several times, patients also present with splenomegaly.…”

“…The duration of symptoms may have a direct impact on the histological and physiological aspects of the liver, and hence the presenting age of the patient may determine the possible outcomes of the therapy and even the prognosis of the disease [12]. With advancing age, the progression in the cavernous transformation is increased, leading to further structural and functional impairment not only in the liver but also in the portosystemic circulation [13].…”

“…Our patient presented at a relatively younger age of nine years. In a study conducted on 30 children with symptomatic CTPV, placement of the shunt to decrease portal pressure was seen to be more effective in younger children and with lesser complications post-intervention as compared to those in the older children [12].…”