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Improved body mass index after mesenterico-portal bypass

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Abstract

Extrahepatic portal hypertension in children secondary to portal vein obstruction is frequently associated with impaired somatic growth. The aim of this study was to assess growth and nutritional status, as reflected by the body mass index (BMI), before and after mesenterico-portal bypass (Rex shunt). Eleven children with a portal vein cavernoma underwent mesenterico-portal bypass using autologous jugular vein. All shunts have remained patent during follow-up periods of 7 months to 5 years. All except one child, who had a normal BMI prior to surgery, demonstrated an increase in their BMI standard deviation scores after surgery. Mean BMI standard deviation scores increased from −0.44 ± 1.28 (95% CI −1.30 to 0.42) to 0.46 ± 1.08 (95% CI −0.27 to 1.19), a highly statistically significant increase (P = 0.003). Restoration of hepatopetal portal blood flow by mesenterico-portal bypass surgery improves nutrition and growth in children with extrahepatic portal hypertension.

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Acknowledgments

I am grateful to colleagues in paediatric hepatology and radiology who were involved in the clinical care of these patients and to the nursing staff who documented their growth parameters. I would also like to thank Dr. Richard Feltbower, Senior Research Fellow in the Paediatric Epidemiology Group, University of Leeds for his help with the BMI standard deviation scores.

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Authors and Affiliations

  1. Children’s Liver and GI Unit, St. James’s University Hospital, Leeds, UK

    Mark D. Stringer

  2. Department of Anatomy and Structural Biology, Otago School of Medical Sciences, University of Otago, PO Box 913, Dunedin, New Zealand

    Mark D. Stringer

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  1. Mark D. Stringer
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Correspondence to Mark D. Stringer.

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Stringer, M.D. Improved body mass index after mesenterico-portal bypass. Pediatr Surg Int 23, 539–543 (2007). https://doi.org/10.1007/s00383-007-1920-z

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  • DOI: https://doi.org/10.1007/s00383-007-1920-z

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