Splenorenal venous shunt and normal drainage of splenic vein: an unusual case report

The presence of splenorenal shunt without existence of any underlying pathology such as liver cirrhosis, portal hypertensionor hepatic encephalopathy, accompanied with normal splenic venous drainage is extremely rare. This case report presents asplenorenal shunt between splenic and left renal vein in a 59-year-old female patient with abdominal pain. No underlyingpathology was present. The splenic embryology and contrast enhanced multidetector computed tomography findings ofsplenorenal shunt have been reported accompanied with a brief review of literature.

___

  • Leonidas JC, Fellows RA. Congenital absence of the ductus veno- sus: With direct connection between the umbilical vein and the distal inferior vena cava. AJR 1976;126:892.
  • Lin YT, Chang CH, Chen WC. Asymptomatic congenital splenorenal shunt in a noncirrhotic patient with a left adrenal aldosterone-producing adenoma. Kaohsiung J Med Sci 2009;25: 669–74.
  • Ohwada S, Hamada Y, Morishita Y, et al. Hepatic encephalopathy due to congenital splenorenal shunts:report of a case. Surg Today 1994;24:145–9.
  • Kiriyama M, Takashima S, Sahara H, et al. Case report: portal-sys- temic encephalopathy due to a congenitalextrahepatic portosys- temic shunt. J Gastroenterol Hepatol 1996;11:626–9. 21
  • Splenorenal venous shunt and normal drainage of splenic vein Anatomy 2014; 8
  • Moore KL, Persaud TVN. The digestive system. In: Moore KL, Persaud TVN, eds. The developing human: Clinically orientated embryology. 6th ed. Philadelphia: Saunders; 1998. p. 217–45.
  • He B, Hamdorf JM. Clinical importance of anatomical variations of renal vasculature during laparoscopic donor nephrectomy. OA Anatomy 2013;18:25–31.
  • Lau ST, Kim SS, Lee SL, Ledbetter DJ. The anomalous splenic vein: a case report and review of the literature. J Pediatr Surg 2005;40:1492–4.
  • Kim W, Shin HC, Kim Y, Bae SB, Park JM. Duplication of the spleen with a short pancreas. Br J Radiol 2009;82:42–3.
  • Ji E, Yoo S, Kim JH, Cho KS. Congenital splenorenal venous shunt detected by prenatal ultrasonography. J Ultrasound Med 1999;18:437–9.
  • Huu N, cited by Barnett CH, Lewis OJ. In: Goldby F, Harrison RJ, eds. Recent advances in anatomy, 2nd series. London: J&A Churchill; 1961. p. 388–92.
  • Wind P, Alves A, Chevallier JM, Gillot C, Sales JP, Sauvanet A, et al. Anatomy of spontaneous splenorenal and gastrorenal venous anastomoses. Review of the literature. Surg Radiol Anat 1998;2: 129–34.
  • Kiriyama M, Takashima S, Sahara H, et al. Porto-systemic encephalopathy due to a congenital extrahepatic portocaval shunt. J Gastroenterol Hepatol 1996;11:626–9.
  • Mitra N, Anandhi C. Congenital splenorenal shunt: a dilemma. Indian Pediatr 2012;49:156–7.
  • Chai JW, Lee W, Yin YH, Jae HJ, Chung JW, Kim HH, et al. CT Angiography for living kidney donors: accuracy, cause of misinter- pretation and prevalence of variation. Korean J Radiol 2008;9: 333–9.
  • Villablanca JP, Rodriguez FJ, Stockman T, Dahliwal S, Omura M, Hazany S, et al. MDCT angiography for detection and quan- tification of small intracranial arteries: comparison with conven- tional catheter angiography. AJR Am J Roentgenol 2007;188:593– 602.
  • Satyapal KS, Haffejee AA, Singh B, Ramsaroop L, Robbs JV, Kalideen JM. Additional renal arteries: incidence and morphome- try. Surg Radiol Anat 2001;23:33–8.