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Review
. 2020 Apr 21;26(15):1726-1732.
doi: 10.3748/wjg.v26.i15.1726. Epub 2020 Apr 14.

Spontaneous porto-systemic shunts in liver cirrhosis: Clinical and therapeutical aspects

Silvia Nardelli  1 , Oliviero Riggio  1 , Stefania Gioia  1 , Marta Puzzono  1 , Giuseppe Pelle  2 , Lorenzo Ridola  3
Affiliations
Review

Spontaneous porto-systemic shunts in liver cirrhosis: Clinical and therapeutical aspects

Silvia Nardelli et al. World J Gastroenterol. .

Abstract

Spontaneous porto-systemic shunts (SPSS) are frequent in liver cirrhosis and their prevalence increases as liver function deteriorates, probably as a consequence of worsening portal hypertension, but without achieving an effective protection against cirrhosis' complications. Several types of SPSS have been described in the literature, each one associated with different clinical manifestations. In particular, recurrent or persistent hepatic encephalopathy is more frequent in patients with splenorenal shunt, while the presence of gastric varices and consequently the incidence of variceal bleeding is more common in gastrorenal shunt. In the advanced stage, the presence of large SPSS can lead to the so called "portosystemic shunt syndrome", characterized by a progressive deterioration of hepatic function, hepatic encephalopathy and, sometimes, portal vein thrombosis. The detection of SPSS in patients with liver cirrhosis is recommended in order to prevent or treat recurrent hepatic encephalopathy or variceal bleeding.

Keywords: Hepatic encephalopathy; Liver cirrhosis; Portal vein thrombosis; Porto-systemic shunt syndrome; Porto-systemic shunts; Variceal bleeding.

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Conflict of interest statement

Conflict-of-interest statement: All authors have nothing to disclose and no conflict of interest.

Figures

Figure 1
Figure 1
Paraumbilical shunt at computed tomography scan.
Figure 2
Figure 2
Gastrorenal shunt at computed tomography scan.
Figure 3
Figure 3
Splenorenal shunt at computed tomography scan.
See this image and copyright information in PMC

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