Infected Dacron mesorenal portosystemic shunt

D. L. Klaminski and W. D. Warren

A serious septicemia developed in a patient two years after placement of a Dacron mesorenal shung for bleeding esophageal varices. The source of the sepsis remained unknown for 13 months and was refractory to antibiotic therapy. Roentgenographic studies showed the shunt to be patent and without intralumenal thrombus. At operation, the shung was being contaminated by a hole in the proximal jejunum and the patient has been cured of sepsis by removing the shunt. In contrast to the presentation of infected prosthesis used in the arterial system, infectious complications of prosthesis used in the portal systemic venous system occur without thrombosis of the shunt, aneurysm formation, or intraintestinal bleeding thus making operative evaluation the only means of diagnosis.