Portacaval shunt

Portacaval shunt
Under normal conditions, blood flows into the liver via the portal vein and exits through the hepatic vein, eventually reaching the inferior vena cava. A portacaval shunt connects the portal vein directly to the inferior vena cava, bypassing the liver entirely.

A portacaval shunt, portocaval shunt, or portal-caval shunt is a surgical procedure where a connection (a shunt) is made between the portal vein and the inferior vena cava.

Under normal circumstances, the portal vein drains blood from the abdomen to the liver. The blood is deoxygenated and carries nutrients and waste products from the intestines, spleen, pancreas, and gallbladder to the liver.[1] The deoxyenated blood then exits the liver through the hepatic vein and empties into the inferior vena cava, the vein that carries blood from the lower two-thirds of the body to the heart.

The portacaval shunt connects the portal vein to the inferior vena cava, allowing blood to travel directly from the portal vein to the inferior vena cava, bypassing the liver entirely. The shunt is typically used to manage complications of portal hypertension, such as upper gastrointestinal bleeding. However, technological advancements have shifted towards minimally invasive methods rather than surgical shunting.

Portal hypertension is commonly seen with liver cirrhosis and/or other liver diseases such as Budd–Chiari syndrome, primary biliary cirrhosis (PBC), and portal vein thrombosis.[2] The purpose of the shunt is to divert blood flow away from the liver, reducing the high pressure in the portal venous system and decreasing the risk of bleeding.[3]

A portacaval anastomosis is analogous in that it diverts circulation; as with shunts and anastomoses generally, the terms are often used to refer to either the naturally occurring forms or the surgically created forms.

  1. ^ Comar, Kevin M.; Sanyal, Arun J. (2004), "Portal Hypertension and Esophageal Varices", Encyclopedia of Gastroenterology, Elsevier, pp. 212–219, doi:10.1016/b0-12-386860-2/00250-1, ISBN 978-0-12-386860-2, retrieved 2024-11-21
  2. ^ Berzigotti, Annalisa; Seijo, Susana; Reverter, Enric; Bosch, Jaime (February 2013). "Assessing portal hypertension in liver diseases". Expert Review of Gastroenterology & Hepatology. 7 (2): 141–155. doi:10.1586/egh.12.83.
  3. ^ Cite error: The named reference :1 was invoked but never defined (see the help page).