c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Distal Splenorenal (Warren) Shunt: 7

A D V E R T I S E M E N T

   
 

The post-sinusoidal obstruction to portal flow of alcoholic cirrhosis raises the pressure in the portal system. The pressure is transmitted to the esophageal submucosal veins via the right and left (coronary) gastric, splenic, gastroepiploic and short gastric veins. The connection of the esophageal plexus of veins to the azygous veins in the chest is a natural porta-systemic route of decompression. The bulging esophageal varices are subject to erosion by passing food, resulting in massive bleeding.     

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Distal Splenorenal (Warren) Shunt: 8

A D V E R T I S E M E N T

   
 

A modified chevron incision was made, dividing both rectus muscles. Meticulous hemostasis was carried out.       

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Distal Splenorenal (Warren) Shunt: 9

A D V E R T I S E M E N T

   
 

The falciform ligament was divided. Note the vascularity indicative of increased portal pressure.       

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This page was last modified on 6/13/2001.