Asymptomatic congenital splenorenal shunt in a noncirrhotic patient with a left adrenal aldosterone-producing adenoma

Kaohsiung J Med Sci. 2009 Dec;25(12):669-74. doi: 10.1016/S1607-551X(09)70573-X.

Abstract

Portosystemic shunts frequently develop in patients with cirrhosis. However, congenital splenorenal shunts are rare anomalies in people without portal hypertension. Here, we present a case of a venous shunt between the spleen and left renal vein in a 57-year-old man with no history of liver cirrhosis, portal hypertension, or hepatic encephalopathy. The abnormal vessel was identified on preoperative contrast-enhanced computed tomography performed for diagnosis of a left adrenal aldosterone-producing adenoma. The shunt was safely ligated during transperitoneal laparoscopic left adrenalectomy. Excessive bleeding due to accidental injury of the shunting vessel during the procedure is a likely complication. Careful review of preoperative computed tomography images and cautious management of this type of shunt, especially in cirrhotic patients, can prevent this serious complication.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / diagnostic imaging
  • Adenoma / metabolism*
  • Adrenal Gland Neoplasms / diagnostic imaging
  • Adrenal Gland Neoplasms / metabolism*
  • Aldosterone / biosynthesis*
  • Humans
  • Kidney / blood supply*
  • Male
  • Middle Aged
  • Spleen / blood supply*
  • Tomography, X-Ray Computed

Substances

  • Aldosterone