Improved body mass index after mesenterico-portal bypass

Extrahepatic portal hypertension in children secondary to portal vein obstruction is frequently associated with impaired somatic growth. The aim of this study was to assess growth and nutritional status, as reflected by the body mass index (BMI), before and after mesenterico-portal bypass (Rex shunt). Eleven children with a portal vein cavernoma underwent mesenterico-portal bypass using autologous jugular vein. All shunts have remained patent during follow-up periods of 7 months to 5 years. All except one child, who had a normal BMI prior to surgery, demonstrated an increase in their BMI standard deviation scores after surgery. Mean BMI standard deviation scores increased from -0.44 +/- 1.28 (95% CI -1.30 to 0.42) to 0.46 +/- 1.08 (95% CI -0.27 to 1.19), a highly statistically significant increase (P = 0.003). Restoration of hepatopetal portal blood flow by mesenterico-portal bypass surgery improves nutrition and growth in children with extrahepatic portal hypertension.