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Multimodality imaging of the Meso-Rex bypass

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Abstract

Extrahepatic portal vein obstruction (EHPVO) is the most common cause of upper gastrointestinal bleeding in children. It is defined as thrombosis of the extrahepatic portal vein with or without extension to the intrahepatic portal veins. The Meso-Rex shunt is the gold standard treatment in children with favorable anatomy since it restores physiological portal liver reperfusion. This is achieved by rerouting the splanchnic venous blood through an autologous graft from the superior mesenteric vein (SMV) into the Rex recess of the left portal vein, curing portal hypertension by doing so. General and hepatobiliary radiologists must be familiar with multimodality imaging appearances of EHPVO and with the role of imaging in identifying suitable candidates for Meso-Rex bypass surgery. Imaging might also detect complications of this procedure, some of which might be treated via interventional radiology.

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Authors and Affiliations

  1. Diagnostic and Therapeutic Services Department, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Via Ernesto Tricomi 5, 90127, Palermo, Italy

    Vincenzo Carollo, Gianluca Marrone, Giuseppe Mamone, Settimo Caruso, Mariapina Milazzo, Luigi Maruzzelli, Fabrizio di Francesco, Roberto Miraglia & Jean de Ville de Goyet

  2. Department of Medical Imaging, Mater Dei Hospital, Msida, MSD 2090, Malta

    Kelvin Cortis

  3. Department of Radiology, Karolinska University Hospital, Huddinge, Sweden

    Martin Delle

Authors
  1. Vincenzo Carollo
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  2. Gianluca Marrone
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  3. Kelvin Cortis
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  4. Giuseppe Mamone
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  5. Settimo Caruso
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  6. Mariapina Milazzo
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  7. Luigi Maruzzelli
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  8. Fabrizio di Francesco
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  9. Martin Delle
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  10. Roberto Miraglia
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  11. Jean de Ville de Goyet
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Correspondence to Kelvin Cortis.

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Carollo, V., Marrone, G., Cortis, K. et al. Multimodality imaging of the Meso-Rex bypass. Abdom Radiol 44, 1379–1394 (2019). https://doi.org/10.1007/s00261-018-1836-1

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  • DOI: https://doi.org/10.1007/s00261-018-1836-1

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