Long-term follow-up result of portopulmonary shunt by splenopneumopexy on membranous obstruction of the inferior vena cava.

A patient with membranous obstruction of the inferior vena cava (MOVC) who underwent portopulmonary shunting by splenopneumopexy 13 years before developed hepatocellular carcinoma (HCC). Postmortem studies revealed HCC in the bilateral lobes of the liver with cirrhosis and complete MOVC. There were numerous new vessel formations in the portion of the splenopneumopexy, which proved persistence of the patency. Clinically, postshunt encephalopathy, hepatic deterioration, and cardiac-respiratory dysfunction in the long-term follow-up period were not noticed. Factors that contributed to the occurrence of HCC are also discussed.