Prevalence and Clinical Characteristics of Spontaneous Splenorenal Shunt in Liver Cirrhosis: A Retrospective Observational Study Based on Contrast-Enhanced Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) Scans

Xingshun Qi, Xiaolong Qi, Yongguo Zhang, Xiaodong Shao, Chunyan Wu, Yongji Wang, Ran Wang, Xintong Zhang, Han Deng, Feifei Hou, Jing Li, Xiaozhong Guo, Xingshun Qi, Xiaolong Qi, Yongguo Zhang, Xiaodong Shao, Chunyan Wu, Yongji Wang, Ran Wang, Xintong Zhang, Han Deng, Feifei Hou, Jing Li, Xiaozhong Guo

Abstract

BACKGROUND This is a retrospective observational study evaluating the prevalence and clinical characteristics of spontaneous splenorenal shunt in liver cirrhosis. MATERIAL AND METHODS We included a total of 105 cirrhotic patients who were admitted to our hospital between June 2012 and December 2013 and underwent contrast-enhanced CT and/or MRI scans at admissions. Spontaneous splenorenal shunt was identified. Clinical and laboratory data were compared between cirrhotic patients with and without spontaneous splenorenal shunt. RESULTS The prevalence of spontaneous splenorenal shunt was 10.5% (11/105). The prevalence of hepatic encephalopathy was higher in patients with spontaneous splenorenal shunt than in those without spontaneous splenorenal shunt (18.2% vs. 4.3%, p=0.062), but the difference between them was not statistically significant. The prevalence of acute upper-gastrointestinal bleeding was lower in patients with spontaneous splenorenal shunt than in those without spontaneous splenorenal shunt (0% vs. 18.1%, p=0.205), but the difference between them was not statistically significant. Patients with spontaneous splenorenal shunt had significantly higher Child-Pugh scores (9.50±1.65 vs. 7.43±2.02, p=0.002) and MELD scores (11.26±7.29 vs. 5.67±6.83, p=0.017) than those without spontaneous splenorenal shunt. In-hospital mortality was similar between them (0% vs. 4.3%, p=1.000). CONCLUSIONS Spontaneous splenorenal shunt might be associated with worse liver function in liver cirrhosis, but not with in-hospital mortality.

Conflict of interest statement

Conflict of interest

None.

Figures

Figure 1
Figure 1
Axial contrast-enhanced computed tomography at the portal vein phase in a 63-year-old female patient with spontaneous splenorenal shunt (HXY). Black dashed arrows represent the inferior vena cava; black solid arrows represent the left renal vein; blue solid arrows represent the splenic vein; red solid arrows represent the communication between splenic vein and left renal vein.
Figure 2
Figure 2
Axial contrast-enhanced MRI scans at the portal vein phase in a 44-year-old male patient with spontaneous splenorenal shunt (MQS). Black dashed arrows represent the inferior vena cava; black solid arrows represent the left renal vein; blue solid arrows represent the splenic vein; red solid arrows represent the communication between splenic vein and left renal vein.

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