Prevention of Recurrent Bleeding: Selective Shunt Operations

  • Layton F. Rikkers


In 1893, Pavlov [1] described the adverse consequences of complete portal diversion. His astute observations of dogs with patent portacaval shunts resulted in the description of the syndrome of “meat intoxication” or portasystemic encephalopathy. Pavlov also noted that sacrificed animals with patent shunts had atrophic livers, whereas dogs with occluded shunts had hepatopetal portal collaterals and normal livers. He concluded from these experiments that hepatic portal perfusion was essential for maintenance of normal hepatic physiology and structure. He also theorized that portal blood contained cerebral toxins absorbed from the intestines which resulted in the psychoneurological disturbances observed in the animals with complete diversion of portal flow.


Splenic Vein Left Renal Vein Portal Flow Portacaval Shunt Endoscopic Sclerotherapy 
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Copyright information

© Springer Japan 1991

Authors and Affiliations

  • Layton F. Rikkers
    • 1
  1. 1.Department of SurgeryUniversity of Nebraska Medical CenterOmahaUSA

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