Meso-Rex bypass in a 7-month-old child with prehepatic portal hypertension
- Authors: Zadvernyuk A.S.1,2, Kulikova N.V.2, Nurik V.I.1,2, Razumovskiy A.Y.1,2, Knyazeva N.A.1
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Affiliations:
- The Russian National Research Medical University named after N.I. Pirogov
- Filatov N.F. Children's City Hospital
- Issue: Vol 28, No 2 (2024)
- Pages: 224-230
- Section: CASE REPORTS
- Submitted: 29.06.2023
- Accepted: 08.09.2023
- Published: 30.05.2024
- URL: https://jps-nmp.ru/jour/article/view/702
- DOI: https://doi.org/10.17816/ps702
- ID: 702
Cite item
Abstract
BACKGROUND: The prehepatic form of portal hypertension is the most common cause of portal hypertension in children. Nowadays mesoportal shunting is the most optimal therapy for such pathology. In the world literature, there are only few publications describing application of such surgical technique in children of the first year of life.
CLINICAL CASE DESCRIPTION: The article describes a case of a 7-month old child with prehepatic portal hypertension who had mesoportal bypass surgery. A month before the surgery, the child had an episode of gastrointestinal bleeding which was treated conservatively. Additional diagnostics before surgery included liver and spleen ultrasound examination, transarterial mesenteric portography, and esophagogastroduodenoscopy. The child was discharged home on the 6th postoperative day. For three months after the surgery, he received antiplatelet therapy and proton pump inhibitors. In 3-months, follow-up ultrasound showed satisfactory blood flow through the shunt. Patient’s weight gain had also a positive trend.
CONCLUSION: Mesoportal bypass surgery is technically achievable in children of the first year of life. In our opinion, patient’s age has a positive impact on creating a functioning mesoportal shunt: the younger the patient, the greater the likelihood of favorable outcome.
Keywords
Full Text
About the authors
Aleksandr S. Zadvernyuk
The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children's City Hospital
Author for correspondence.
Email: drsasha81@yandex.ru
ORCID iD: 0000-0003-4379-8051
SPIN-code: 8803-6595
MD, Cand. Sci. (Medicine)
Россия, Ostrovityanova street, 1, buil. 7, Moscow; 15 Sadovaya-Kudrinskaya street, 123001 MoscowNadezhda V. Kulikova
Filatov N.F. Children's City Hospital
Email: dr.kulikovan.v@gmail.com
ORCID iD: 0000-0003-0834-2630
SPIN-code: 4687-1558
MD, Cand. Sci. (Medicine)
Россия, 15 Sadovaya-Kudrinskaya street, 123001 MoscowVera I. Nurik
The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children's City Hospital
Email: vera.nurik@mail.ru
ORCID iD: 0009-0002-6025-1357
SPIN-code: 1431-2990
MD, Cand. Sci. (Medicine)
Россия, Ostrovityanova street, 1, buil. 7, Moscow; 15 Sadovaya-Kudrinskaya street, 123001 MoscowAleksander Yu. Razumovskiy
The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children's City Hospital
Email: 1595105@mail.ru
ORCID iD: 0000-0002-9497-4070
SPIN-code: 3600-4701
MD, Dr. Sci. (Medicine), Professor
Россия, Ostrovityanova street, 1, buil. 7, Moscow; 15 Sadovaya-Kudrinskaya street, 123001 MoscowNatalia A. Knyazeva
The Russian National Research Medical University named after N.I. Pirogov
Email: nata-knya@yandex.ru
ORCID iD: 0009-0004-0771-6922
SPIN-code: 8851-7247
Россия, 15 Sadovaya-Kudrinskaya street, 123001 Moscow
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