A case of a spontaneous splenorenal shunt associated with the nutcracker syndrome

BACKGROUND Hypertension in the portal vein system stimulates the vascular system to develop a porto-caval collateral system, which occurs by adaptation of the already existing junctions between the porto-caval and the systemic circulation to changed conditions or by angiogenesis. CASE REPORT We present a case of a 42-year-old man with alcoholic cirrhosis of the liver and exacerbation of chronic pancreatitis, whose computed tomography of the abdominal cavity revealed a massive varicoid dilatation of a vein of the spleen with a splenorenal shunt and tortuous dilated venous vessels in the retroperitoneal space and mesentery. CONCLUSIONS The unusual image of the mesenteric and retroperitoneal venous vessels in our patient resulted from the coexistence of collateral porto-systemic circulation and compression of the left renal vein.