Spontaneous porto-systemic shunts in liver cirrhosis: Clinical and therapeutical aspects

Table 1 Clinical features of the main spontaneous porto-systemic shunts

SPSS type	Frequency	Clinical presentation (if any)	Laterality
Gastrorenal shunt	80%-85% of patients with gastric varices	Gastric varices bleeding, less frequently hepatic encephalopathy or portal vein thrombosis if very large	Left
Gastrocaval shunt	Less frequent than gastrorenal shunt	Gastric varices bleeding	Left
Splenorenal shunt	14%-21% of patients with cirrhosis	Hepatic encephalopathy; Portal vein thrombosis	Left
Mesorenal shunt	Uncommon	Hepatic encephalopathy	Central
Paraumbilical shunt	6%-30% of patients with portal hypertension	Hepatic encephalopathy Portal vein thrombosis	Right
Rectal varices	Rare	Lower gastro-intestinal bleeding	Right
Esophageal varices	40%-80% of patients with cirrhosis	Hematemesis or melena	Right

SPSS: Spontaneous porto-systemic shunt.