Thrombosed mesocaval shunt: salvage by mechanical thrombolysis. Case report and review of the literature

Abstract

We report the case of a 27-year-old male who presented with acute mesocaval shunt thrombosis, which was successfully managed by mechanical thrombolysis. Shunt thrombosis was suspected when the patient showed clinical signs and symptoms of obstructive jaundice in the immediate postoperative period. Doppler sonography showed absence of flow across the shunt, suggestive of thrombosis, which was mechanically thrombolyzed by a percutaneous approach. The portocaval pressure gradient noted at the end of procedure was <5 mm Hg. The shunt remained patent at the end of 3 months' follow-up.