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Pediatric Radiology
Published in: Pediatric Radiology 2/2012

01-02-2012 | Pictorial Essay

Pre- and postoperative imaging and interventions for the meso-Rex bypass in children and young adults

Authors: Ian J. Chaves, Cynthia K. Rigsby, Samantha E. Schoeneman, Stanley T. Kim, Riccardo A. Superina, Tamar Ben-Ami

Published in: Pediatric Radiology | Issue 2/2012

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Abstract

The meso-Rex bypass is a physiological and anatomical bypass procedure for relief of extrahepatic portal vein obstruction and restoration of mesenteric venous return to the liver. Most patients who are candidates for the bypass are children or young adults with portal hypertension and hypersplenism secondary to cavernous transformation of the portal vein. Most frequently, the bypass utilizes an autologous venous graft to connect the intrahepatic left portal vein to the infrapancreatic superior mesenteric vein (SMV) re-establishing first-pass portal perfusion. We describe the preoperative imaging of the 92 bypass candidates, the surgical anatomy as reflected in postoperative imaging, and the imaging of bypass complications at our institution.
Preoperative imaging with US, CT and MR is directed to demonstrate patency and size of the left portal vein and SMV, to define the extent of cavernous transformation and splanchnic collaterals, and to assess for any associated abdominal vascular or solid organ abnormalities. Postoperative imaging is aimed at diagnosing meso-Rex bypass stenosis or occlusion and the interventional management of these complications.
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Metadata
Title
Pre- and postoperative imaging and interventions for the meso-Rex bypass in children and young adults
Authors
Ian J. Chaves
Cynthia K. Rigsby
Samantha E. Schoeneman
Stanley T. Kim
Riccardo A. Superina
Tamar Ben-Ami
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 2/2012
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-011-2283-0

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