PATENCY EVALUATION OF DISTAL SPLENORENAL SHUNT WITH DYNAMIC COMPUTED-TOMOGRAPHY

Abstract

The reliability of documenting the patency of a shunt by dynamic computed tomographic angiography was compared with postoperative celiac arteriography done in 13 patients who had had a distal splenorenal shunt 1 mo.-6 yr earlier. This new technique confirmed the arteriographic diagnosis regarding patency of the shunt in 11 patients and demonstrated patency in 2 with indeterminant, or probably occluded, shunts by arteriography. Its reliability as an alternative diagnostic tool was prejudged by a standard technique which was less than optimal in precision, and it still contained no false-negative results in this small group of patients. The dynamic scan had excellent patient acceptance for interval follow-up examination as an outpatient study. It is appropriate for the assessment of patency early after operation, or later, as a routine follow-up study or in patients with persistent varices or bleeds from an uncertain upper gastrointestinal source.