Sonographic features of umbilical vein recanalization for a Rex shunt on cavernous transformation of portal vein in children

Figure 1 Color Doppler ultrasonography of a 9-year-old boy after recanalized umbilical vein as a conduit for Rex shunt (gastric coronary vein-umbilical vein shunt). A: Color Doppler flow imaging (CDFI)showed intermittent blood flow signal in the bypass vessel (gastric coronary vein) 7 d after operation; B: CDFI showed that the bypass vessel was well filled with blood flow signals after clinical anticoagulation treatment for 3 mo. Long arrow indicates umbilical vein and short arrow indicates gastric coronary vein.

Figure 2 Color Doppler ultrasonography of a 7-year-old boy after classic Rex shunt (splenic vein-left portal vein shunt). A: Color Doppler flow imaging (CDFI) showed stellate blood flow signal in the bypass vessel (splenic vein) 7 d after operation; B: CDFI showed that the internal blood flow signal of the bypass vessel filling was good; C: Flow velocity of the middle part of the bypass vessel was 19.6 cm/s. Arrow indicates splenic vein.

Figure 3 Color Doppler ultrasonography of a 13-year-old boy after recanalized umbilical vein as a conduit for Rex shunt (splenic vein-umbilical vein shunt) operation. The boy was admitted to the hospital with hematemesis and black stool. A: Color Doppler flow imaging showed no blood flow signal in the bypass vessel (splenic vein) 7 d after operation; B: Color Doppler flow imaging showed no blood flow signal in the bypass vessel after clinical anticoagulation treatment for 3 mo. Arrow indicates splenic vein.

Figure 4 Grayscale and color Doppler ultrasonography of an 8-year-old girl after recanalized umbilical vein as a conduit for Rex shunt. A: Grayscale ultrasonography; B: Color Doppler ultrasonography. The girl was admitted to hospital with intermittent hematemesis and black stool. Bypassing the main portal vein with the umbilical vein was conducted through the splenic vein. The bypass vessel (splenic vein) and anastomoses were clearly displayed 7 d after operation. Long arrow indicates umbilical vein and short arrow indicates splenic vein.