Search

Extra-hepatic portal vein obstruction can cause severe portal hypertension. Meso-rex shunting is a surgical option to bypass the extrahepatic portal venous obstruction, connecting the superior mesenteric vein to the left portal vein, restoring hepato-petal blood flow. This is an alternative to porto-systemic shunts (e.g. spleno-renal shunt)in a setting of normal liver function and intrahepatic vasculature. Our case is of a 3yo patient who underwent meso-rex shunt creation, which was complicated by thrombosis and recurrent varices and ascites. Percutaneous recanalization and stenting via a trans-splenic approach was successful, and the shunt remained patent at follow up at 1,3, and 5 months.

Undifferentiated embryonal sarcoma of the liver (UESL) is a rare but aggressive pediatric tumor. Historically, treatment for UESL has consisted of combination therapy with surgical resection and chemotherapy. In some cases, surgical resection is not appropriate due to limiting factors such as tumor size, location, and lack of response to treatment. Orthotopic liver transplant (OLT) has been suggested as a promising alternative in these cases. We present a case of an 8 year-old boy with a large undifferentiated embryonal sarcoma of the liver who experienced disease progression after initial neoadjuvant chemotherapy. His tumor was considered unresectable after internal tumor board review due to its size and significant vascularity, ultimately making OLT the only curative option for this patient. Keywords: Undifferentiated embryonal sarcoma of the liver, Pediatric liver tumors, Orthotopic liver transplant, Pediatric liver transplantation