How do you determine when you would treat an identified spleno-renal shunt and how?  

It is important to remember that the typical reason portal hypertension develops is to try and accommodate the increased resistance across the cirrhotic liver. A spleno-renal shunt is a congenital malformation that is often noted when a patient develops portal hypertension. Prior to TIPS, these were...

To add to Dr. @Victor's response, I mainly first look for these when there are cases of refractory or persistent episodes of hepatic encephalopathy. This would be the first symptom of a functionally significant SRS. If standard measures are not working for HE management, then I make sure we have a g...