Renal Vein Thrombosis Distal to Patent Splenorenal Shunt

To the Editor.— Thrombosis of the portal system frequently complicates splenorenal shunts. Occasionally the renal vein is occluded with the shunt. We report a case with late thrombosis of the distal segment of the left renal vein but with the unusual feature of patency of the splenorenal shunt. Report of a Case.— A 55-year-old white man entered the hospital with a three-day history of pain in the left flank after lifting a heavy object. The patient had had a splenorenal shunt constructed 38 months earlier because of Laennec's cirrhosis. Two months before the present illness, when he had symptoms of urinary tract infection, the blood urea nitrogen (BUN) and serum creatinine concentrations and an excretory urogram were normal. Pyuria and bacteriuria due to Escherichia coli were treated with ampicillin. He was dehydrated and jaundiced, and had lost 11 lb since the previous admission. The liver was not enlarged. There was