mitra shunt (spleen preserving, side to side lieno-renal shunt) for portal hypertension with hypersplenism in early infancy

Extrahepatic portal vein obstruction (EHPVO) is the commonest cause of portal hypertension presenting with gastrointestinal bleeding and splenomegaly. Medical management of this condition may provide relief, but involves repeated hospital visits and endoscopic procedures. Surgery is an effective curative solution by lowering portal venous pressure with effective shunting of venous blood from splanchnic to systemic circulation. Shunt surgery for such a small baby has not been previously reported and splenectomy has its own problems. Similarly, banding or sclerotherapy in such babies is not without risk. Among the various shunt options, Mitra shunt (spleen preserving, side-to-side lienorenal shunt), developed and standardized in our own country, stands out as the most optimum surgical treatment for EHPVO in early infancy. We report a 4-month-old baby, youngest recipient of Mitra shunt reported in literature with successful outcome.