Bleeding oesophageal varices caused by the Budd-Chiari syndrome treated by the Warren shunt.

A previously healthy nonalcoholic 21-year old man was admitted to the hospital for further investigation because of previous severe haematemesis. Oesophageal varices proved to be the origin of the bleeding. The underlying cause for portal hypertension was total obstruction of the left and 70% obstruction of the right hepatic veins (chronic Budd-Chiari syndrome). Portal flow to the liver was almost normal due to well developed collaterals to the azygos vein and the patient's liver function was good. Distal splenorenal shunt (Warren shunt) was performed to decompress the varices. Postoperative recovery was uneventful and 10 months later the patient's general condition was excellent. Varices had disappeared and there was also improvement in his haematological status.