Abnormal left renal vein. No barrier to Warren shunt.

The purpose of the distal splenorenal shunt is to provide decompression of gastroesophageal varices while avoiding insult to the diseased liver. However, the technical difficulty of the operation has prevented widespread application of the procedure. It is important, therefore, that the technical problems an hazards of the operation continue to undergo analysis. This report has described successful establishment of a Warren shunt in three patients with abnormalities of the left renal vein. Previous left nephrectomy or an anomaly of the left renal vein does not preclude the use of the distal splenorenal shunt in the treatment of variceal hemorrhage.