Two cases of portal-systemic shunts demonstrated by portal venography performed by operative cannulation of ileocolic vein.

Two cases of portal-systemic shunt were presented. A 70 year-old cirrhotic female, who was suffered from mental confusion, underwent portal venography which demonstrated a large varicose vein connecting the inferior mesenteric vein with the left renal vein. The mean portal pressure was 15 cm saline. There were no esophagogastric varices. A 47 year-old cirrhotic female, who was admitted for evaluation of liver dysfunction found incidentally, underwent portal venography which revealed a dilated coronary vein connecting to the left renal vein. The portal pressure was 23 cm saline. There was no evidence of esophageal varices. Portal venography was performed through the ileocolic vein in both cases. In general, bleeding varices may develop most commonly in coronary-azygous system and less frequently in the territory of the superior and inferior mesenteric veins. On the contrary, retroperitoneal portal-systemic shunts is likely to cause hepatic encephalopathy rather than to develop bleeding varices. Thus, it is necessary to perform abdominal angiography in patients with hematochezia of unknown etiology or recurrent episodes of hepatic encephalopathy.