Radiological anatomy of spontaneous splenorenal shunts in patients with chronic liver disease

Abstract

We evaluated anatomical variations of spontaneous splenorenal shunt (SSRS) and the prevalence of portosystemic shunts in patients with chronic liver disease by CT. A total of 451 patients with chronic liver disease underwent contrast-enhanced computed tomography between October 2010 and April 2011. The prevalence of portosystemic shunts including SSRS and gastrorenal shunt, and the frequency of hepatic encephalopathy were examined. The course of the shunt and the point of confluence with the renal vein of the SSRS were analyzed. SSRSs or gastrorenal shunts were found in 11.1 and 5.0% of the patients, respectively. Anatomical variations were classified into three types according to the point of confluence as follows: type 1=the SSRS joined the inferior phrenic vein (n=33), type 2=the SSRS joined the gonadal vein (n=7), and type 3=the SSRS joined the left renal vein (n=14). The course of the SSRS from the splenic hilum was classified as medial (n=46), posterior (n=2), or anterolateral (n=2). SSRSs were classified into three types depending on the confluence point with the renal vein, and into three types of course. These findings are useful for preoperative information.