Demonstration of Surgical Portasystemic Venous Shunts by Scintisplenoportography*

Abstract

Scintisplenoportography (SSP) was used to assess shunt patency in 15 patients with surgically created portasystemic venous shunts, and proved to be a simple, safe and accurate technique for demonstrating the patency of both mesocaval H grafts and distal lienorenal shunts. SSP was as accurate as angiography in confirming shunt patency, but was simpler to perform and resulted in less radiation exposure to the patient. The direction and distribution of blood flow within the splanchnic venous system was different to that obtained by angiography. It is postulated that SSP may well reflect portal hemodynamics more accurately than angiography. In patients with patent mesocaval H grafts SSP demonstrated the complete diversion of splanchnic venous blood through the shunt into the systemic venous circulation. The mesocaval H graft is apparently hemodynamically similar to other side to side portacaval shunts.