Meso-Rex bypass in a 7-month-old child with prehepatic portal hypertension

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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.

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作者简介

Aleksandr Zadvernyuk

The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children's City Hospital

编辑信件的主要联系方式.
Email: drsasha81@yandex.ru
ORCID iD: 0000-0003-4379-8051
SPIN 代码: 8803-6595

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Ostrovityanova street, 1, buil. 7, Moscow; 15 Sadovaya-Kudrinskaya street, 123001 Moscow

Nadezhda Kulikova

Filatov N.F. Children's City Hospital

Email: dr.kulikovan.v@gmail.com
ORCID iD: 0000-0003-0834-2630
SPIN 代码: 4687-1558

MD, Cand. Sci. (Medicine)

俄罗斯联邦, 15 Sadovaya-Kudrinskaya street, 123001 Moscow

Vera 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 代码: 1431-2990

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Ostrovityanova street, 1, buil. 7, Moscow; 15 Sadovaya-Kudrinskaya street, 123001 Moscow

Aleksander 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 代码: 3600-4701

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Ostrovityanova street, 1, buil. 7, Moscow; 15 Sadovaya-Kudrinskaya street, 123001 Moscow

Natalia Knyazeva

The Russian National Research Medical University named after N.I. Pirogov

Email: nata-knya@yandex.ru
ORCID iD: 0009-0004-0771-6922
SPIN 代码: 8851-7247
俄罗斯联邦, 15 Sadovaya-Kudrinskaya street, 123001 Moscow

参考

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2. Fig. 1. Preoperative transarterial mesentericoportography.

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3. Fig. 2. Intraoperative picture.

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4. Fig. 3. Child in 3 months after the surgery.

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版权所有 © Zadvernyuk A.S., Kulikova N.V., Nurik V.I., Razumovskiy A.Y., Knyazeva N.A., 2024

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